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
Fax: (815) 756-2944
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528405511 NPPES
Illinois Other 25768 CADC

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