Provider Demographics
NPI:1649009135
Name:DR. DUKE NOVAK LLC
Entity type:Organization
Organization Name:DR. DUKE NOVAK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:NOVAK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:847-857-9860
Mailing Address - Street 1:400 LAKE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:ROSELLE
Mailing Address - State:IL
Mailing Address - Zip Code:60172-3572
Mailing Address - Country:US
Mailing Address - Phone:331-465-9679
Mailing Address - Fax:
Practice Address - Street 1:400 LAKE ST STE 200
Practice Address - Street 2:
Practice Address - City:ROSELLE
Practice Address - State:IL
Practice Address - Zip Code:60172-3572
Practice Address - Country:US
Practice Address - Phone:331-465-9679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health