Healthcare Provider Details

I. General information

NPI: 1588315030
Provider Name (Legal Business Name): EMILY K MAJKRZAK LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2022
Last Update Date: 03/04/2022
Certification Date: 03/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 MANCHESTER RD STE 501-1
WHEATON IL
60187-4579
US

IV. Provider business mailing address

2711 HOBSON RD APT 5
WOODRIDGE IL
60517-1505
US

V. Phone/Fax

Practice location:
  • Phone: 331-716-2449
  • Fax:
Mailing address:
  • Phone: 708-603-1158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150106913
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: