Provider Demographics
NPI:1679454342
Name:TAYLOR, CHRYSSE PRENCESS
Entity type:Individual
Prefix:
First Name:CHRYSSE
Middle Name:PRENCESS
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 E 50TH PL APT 14A
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-6121
Mailing Address - Country:US
Mailing Address - Phone:312-402-4381
Mailing Address - Fax:
Practice Address - Street 1:1617 E 50TH PL APT 14A
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-6121
Practice Address - Country:US
Practice Address - Phone:312-402-4381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0300471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical