Provider Demographics
NPI:1730338617
Name:CZUPRYNA, JOANNA IZABELA (PSYD)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:IZABELA
Last Name:CZUPRYNA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:IZABELA
Other - Last Name:HUK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:1786 MOON LAKE BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-5029
Mailing Address - Country:US
Mailing Address - Phone:847-755-8090
Mailing Address - Fax:847-843-7393
Practice Address - Street 1:1786 MOON LAKE BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-5029
Practice Address - Country:US
Practice Address - Phone:847-755-8090
Practice Address - Fax:847-843-7393
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.007411101YM0800X
IL071-008550103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health