Koenitz-Hudac, Anita

Koenitz-Hudac, Anita is an individual health care provider with primary practice located at 929 Edgewood Rd , Highland Park IL 60035-4623. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Koenitz-Hudac, Anita can be contacted via phone (224) 765-3214.

Contact Information

Primary practice address
929 Edgewood Rd Highland Park IL 60035-4623
Phone: (224) 765-3214
Fax: (224) 765-3214
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X

Profile Details

NPI number 1386151256
LBN Legal business name Koenitz-Hudac, Anita
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 2nd, 2018
Last updated Jan 2nd, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386151256 NPPES
Illinois MEDICAID 16213556

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