Healthcare Provider Details

I. General information

NPI: 1568702546
Provider Name (Legal Business Name): KATHRYN FRANCES TABISZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHRYN FRANCES PERSSON

II. Dates (important events)

Enumeration Date: 02/27/2013
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 W ROOSEVELT RD STE A1
WHEATON IL
60187-2301
US

IV. Provider business mailing address

600 W ROOSEVELT RD STE A1
WHEATON IL
60187-2301
US

V. Phone/Fax

Practice location:
  • Phone: 630-557-6567
  • Fax: 630-557-6567
Mailing address:
  • Phone: 630-557-6567
  • Fax: 630-557-6567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: