Kubasak, Wayne J

Kubasak, Wayne J is an individual health care provider with primary practice located at 525 E Grant St , Macomb IL 61455-3313. He recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as his primary health care specialty. Kubasak, Wayne J can be contacted via phone (309) 833-4101.

Contact Information

Primary practice address
525 E Grant St Macomb IL 61455-3313
Phone: (309) 833-4101
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X Illinois

Profile Details

NPI number 1982821716
LBN Legal business name Kubasak, Wayne J
Credentials MS, LCPC
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2007
Last updated Jul 8th, 2007 - about 19 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 1982821716 NPPES
Illinois Other 032495 HEALTH ALLIANCE

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