Provider Demographics
NPI:1427150101
Name:MOJICA, DOUNGKWAN JOYCE (PSYD, CADC)
Entity type:Individual
Prefix:
First Name:DOUNGKWAN
Middle Name:JOYCE
Last Name:MOJICA
Suffix:
Gender:F
Credentials:PSYD, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3224 N KILBOURN AVE UNIT 6
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-4587
Mailing Address - Country:US
Mailing Address - Phone:773-251-4605
Mailing Address - Fax:
Practice Address - Street 1:3946 N LOWELL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-2843
Practice Address - Country:US
Practice Address - Phone:773-251-4605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071007652103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical