Provider Demographics
NPI:1932890126
Name:PADZENSKY, DEBBY
Entity type:Individual
Prefix:
First Name:DEBBY
Middle Name:
Last Name:PADZENSKY
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 1:1780 CAROL CT
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-2078
Mailing Address - Country:US
Mailing Address - Phone:847-312-2846
Mailing Address - Fax:
Practice Address - Street 1:191 WAUKEGAN RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-2756
Practice Address - Country:US
Practice Address - Phone:847-251-7350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490226291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical