Provider Demographics
NPI:1033446992
Name:MUZIKA, KEATON CLAUSS (PHD)
Entity type:Individual
Prefix:DR
First Name:KEATON
Middle Name:CLAUSS
Last Name:MUZIKA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:KEATON
Other - Middle Name:CLAUSS
Other - Last Name:MUZIKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1940 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-2360
Mailing Address - Country:US
Mailing Address - Phone:603-491-7462
Mailing Address - Fax:
Practice Address - Street 1:1940 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-2360
Practice Address - Country:US
Practice Address - Phone:603-491-7462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-12
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY080084104100000X
CO099236411041C0700X
IL071010202103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical