Provider Demographics
NPI:1407068331
Name:GERALDINE KATZ-ATKIN P C
Entity type:Organization
Organization Name:GERALDINE KATZ-ATKIN P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:GERALDINE
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:KATZ-ATKIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:630-942-9370
Mailing Address - Street 1:255 E LIBERTY DR APT 605
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-5428
Mailing Address - Country:US
Mailing Address - Phone:630-269-3726
Mailing Address - Fax:
Practice Address - Street 1:255 E LIBERTY DR APT 605
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-5428
Practice Address - Country:US
Practice Address - Phone:630-269-3726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490037541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1041CO700XMedicare UPIN