Provider Demographics
NPI:1629872346
Name:CZECH, NICHOLAS (LSW)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:CZECH
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1289 WINDHAM PKWY
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-1763
Mailing Address - Country:US
Mailing Address - Phone:630-759-0201
Mailing Address - Fax:
Practice Address - Street 1:30 PHELPS AVE
Practice Address - Street 2:
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446-1335
Practice Address - Country:US
Practice Address - Phone:630-391-1360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150112742104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker