Provider Demographics
NPI:1760359251
Name:HENKEL-HITZEMANN, ERIN ROSE
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:ROSE
Last Name:HENKEL-HITZEMANN
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 1:614 STUART DR
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-4409
Mailing Address - Country:US
Mailing Address - Phone:630-915-1675
Mailing Address - Fax:
Practice Address - Street 1:1475 ROYAL BLVD
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-2040
Practice Address - Country:US
Practice Address - Phone:847-531-8420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health