Provider Demographics
NPI:1336989532
Name:RYCHTANEK, MADISON ROSE (LPC, ATR-P)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:ROSE
Last Name:RYCHTANEK
Suffix:
Gender:X
Credentials:LPC, ATR-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 AUTUMN DR
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:IL
Mailing Address - Zip Code:60002-2413
Mailing Address - Country:US
Mailing Address - Phone:224-545-9411
Mailing Address - Fax:
Practice Address - Street 1:3115 N WILKE RD STE HIO
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1400
Practice Address - Country:US
Practice Address - Phone:847-975-5598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.020049103TC1900X
IL23-508221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling