Provider Demographics
NPI:1548446339
Name:CZUB, RON JOSEPH (LCPC)
Entity type:Individual
Prefix:MR
First Name:RON
Middle Name:JOSEPH
Last Name:CZUB
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 COUNTRY LN
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-4199
Mailing Address - Country:US
Mailing Address - Phone:708-305-0458
Mailing Address - Fax:
Practice Address - Street 1:1212 COUNTRY LN
Practice Address - Street 2:
Practice Address - City:LEMONT
Practice Address - State:IL
Practice Address - Zip Code:60439-4199
Practice Address - Country:US
Practice Address - Phone:708-305-0458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-11
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.004298101YP2500X
IL108.004298101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional