Provider Demographics
NPI:1609218957
Name:BARTKIEWICZ, TANYA (LPC)
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:BARTKIEWICZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 W HIGGINS RD STE 105
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-2040
Mailing Address - Country:US
Mailing Address - Phone:888-906-4675
Mailing Address - Fax:
Practice Address - Street 1:2500 W HIGGINS RD STE 105
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-2040
Practice Address - Country:US
Practice Address - Phone:888-906-4675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-26
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.008084101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional