Provider Demographics
NPI:1881708188
Name:KLUCZYNSKI, JOHN HILARY (PSYD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HILARY
Last Name:KLUCZYNSKI
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16748 S 181ST LN
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-1031
Mailing Address - Country:US
Mailing Address - Phone:708-275-4583
Mailing Address - Fax:
Practice Address - Street 1:1100 JORIE BLVD STE 272
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-4426
Practice Address - Country:US
Practice Address - Phone:708-275-4583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071003230103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical