Provider Demographics
NPI:1104127471
Name:KRATZ, NANCY ANN (PHD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:ANN
Last Name:KRATZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30W171 MACK RD
Mailing Address - Street 2:
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-1121
Mailing Address - Country:US
Mailing Address - Phone:630-393-6140
Mailing Address - Fax:
Practice Address - Street 1:1819 BAY SCOTT CIR
Practice Address - Street 2:SUITE 109
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-1129
Practice Address - Country:US
Practice Address - Phone:630-357-2456
Practice Address - Fax:630-357-2482
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071004076103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical