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General NPI Number Information
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NPI Number | 1669946653
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Entity Type | Individual
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Provider Name | JOHN KUZELKA
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Gender | Male
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Dates
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Enumeration Date | 01/14/2019
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Last Update Date | 01/14/2019
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Provider Practice Location Address
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Address Line | 3385 N ARLINGTON HEIGHTS RD
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004-7702
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Country | US
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Telephone | 847-890-3223
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Fax |
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Provider Business Mailing Address
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Address Line | 708 THOMPSON AVE
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City | NORTH AURORA
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State | IL
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Zip | 60542-9130
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Country | US
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Telephone | 847-372-7155
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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