Provider Demographics
NPI:1194792705
Name:DUDEK, FELICIA ANNE (MS LCPC CADC)
Entity type:Individual
Prefix:MRS
First Name:FELICIA
Middle Name:ANNE
Last Name:DUDEK
Suffix:
Gender:F
Credentials:MS LCPC CADC
Other - Prefix:
Other - First Name:FELICIA
Other - Middle Name:ANNE
Other - Last Name:FUNK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4049 BORDEAUX DR
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2139
Mailing Address - Country:US
Mailing Address - Phone:847-729-3548
Mailing Address - Fax:847-714-1596
Practice Address - Street 1:30 NORTH MICHIGAN AV
Practice Address - Street 2:ROOM 1926
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3615
Practice Address - Country:US
Practice Address - Phone:847-729-3548
Practice Address - Fax:847-714-1597
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor