Provider Demographics
NPI:1548654635
Name:BUDYN, KASIA
Entity type:Individual
Prefix:
First Name:KASIA
Middle Name:
Last Name:BUDYN
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 1:10081 W LINCOLN HWY
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-1272
Mailing Address - Country:US
Mailing Address - Phone:815-313-2100
Mailing Address - Fax:815-345-3177
Practice Address - Street 1:10081 W LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-1272
Practice Address - Country:US
Practice Address - Phone:815-313-2100
Practice Address - Fax:815-345-3177
Is Sole Proprietor?:No
Enumeration Date:2015-03-26
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178010829101YP2500X
IL180.010300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional