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General NPI Number Information
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NPI Number | 1073440764
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Entity Type | Organization
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Legal Business Name | KEVIN CRYSTAL COUNSELING P.C.
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Dates
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Enumeration Date | 05/06/2026
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Last Update Date | 05/06/2026
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Provider Practice Location Address
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Address Line | 636 CHURCH ST STE 511
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City | EVANSTON
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State | IL
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Zip | 60201-4581
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Country | US
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Telephone | 773-972-5844
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Fax |
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Provider Business Mailing Address
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Address Line | 636 CHURCH ST STE 511
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City | EVANSTON
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State | IL
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Zip | 60201-4581
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Country | US
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Telephone | 773-972-5844
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Fax |
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Authorized Official
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Title or Position | COUNSELOR/ PRESIDENT
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Name | MR. KEVIN FREDERICK CRYSTAL
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Credential | LCPC
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Telephone | 847-440-4838
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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