Provider Demographics
NPI:1265914527
Name:CHRZAN, HOPE F (RBT-18-63852)
Entity type:Individual
Prefix:
First Name:HOPE
Middle Name:F
Last Name:CHRZAN
Suffix:
Gender:F
Credentials:RBT-18-63852
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1453 OAKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-6615
Mailing Address - Country:US
Mailing Address - Phone:847-848-2635
Mailing Address - Fax:
Practice Address - Street 1:1453 OAKWOOD AVE
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-6615
Practice Address - Country:US
Practice Address - Phone:847-848-2635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL18-63852106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician