Provider Demographics
NPI:1235869017
Name:BURLENSKI, RICHARD III
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:
Last Name:BURLENSKI
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5055 N DAMEN AVE APT 2W
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-1341
Mailing Address - Country:US
Mailing Address - Phone:724-503-7274
Mailing Address - Fax:
Practice Address - Street 1:25 E WASHINGTON ST STE 1023
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1710
Practice Address - Country:US
Practice Address - Phone:312-884-1595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-14
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health