Provider Demographics
NPI:1972345569
Name:GLUSZAK, IZABELA (LCSW)
Entity type:Individual
Prefix:
First Name:IZABELA
Middle Name:
Last Name:GLUSZAK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2172 N STAVE ST APT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-2390
Mailing Address - Country:US
Mailing Address - Phone:773-956-0151
Mailing Address - Fax:
Practice Address - Street 1:4700 N RAVENSWOOD AVE STE C
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-8098
Practice Address - Country:US
Practice Address - Phone:773-754-7441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490266461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical