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General NPI Number Information
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NPI Number | 1154128049
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Entity Type | Individual
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Provider Name | DESIREE JEMS KRENZ
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Gender | Female
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Dates
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Enumeration Date | 02/27/2025
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 707 LAKE COOK RD STE 312
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City | DEERFIELD
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State | IL
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Zip | 60015-4933
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Country | US
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Telephone | 877-486-4140
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Fax |
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Provider Business Mailing Address
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Address Line | 1138 JOHNSON DR APT 3311
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City | BUFFALO GROVE
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State | IL
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Zip | 60089-6514
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Country | US
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Telephone | 847-372-5929
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XM0800X
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Taxonomy Name | Mental Health Occupational Therapist
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License Number |
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License Number State |
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