Kapustianyk, Matthew
Kapustianyk, Matthew is an individual health care provider with primary practice located at 12 Health Services Dr , Dekalb IL 60115-9637. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Kapustianyk, Matthew can be contacted via phone (815) 756-4875.Contact Information
Primary practice address
12 Health Services Dr
Dekalb IL 60115-9637
Phone: (815) 756-4875
Fax: (815) 756-2944
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 25768 | Illinois |
Profile Details
| NPI number | 1528405511 |
|---|---|
| LBN Legal business name | Kapustianyk, Matthew |
| Credentials | CADC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 30th, 2013 |
| Last updated | May 30th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528405511 | NPPES |
| Illinois | Other | 25768 | CADC |
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