Provider Demographics
NPI:1861571069
Name:CRUNKILTON-STIEGEL, DONNA (LCSW)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:
Last Name:CRUNKILTON-STIEGEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7643
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-7002
Mailing Address - Country:US
Mailing Address - Phone:847-266-2707
Mailing Address - Fax:847-782-1994
Practice Address - Street 1:501 N RIVERSIDE DR
Practice Address - Street 2:SUITE 201
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-5918
Practice Address - Country:US
Practice Address - Phone:847-266-2707
Practice Address - Fax:847-782-1994
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-004134101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor