Doctor Name: | MR. JOHN ANDREW BUDZYNSKI |
NPI Number: | 1265447064 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.A, L.C.P.C. |
License Number: | |
Business Practice Address: | 7124 Windsor Lake Pkwy Suite # 10 Loves Park, IL - 611113800 |
Business Phone Number: | 8156338688 |
Business Fax Number: | 8156338299 |
Mailing Address: | 7124 Windsor Lake Pkwy, Suite # 10 LOVES PARK |
State: | IL |
Postal Code: | 611113800 |
Phone Number: | 8156338688 |
Fax Number: | 8156338299 |
NPI Enumeration Date: | 07/30/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |