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MITCHELL KRUCKENBERG MED, LPC
NPI 1184411712
Counselor - Mental Health in Melrose Park, IL

Active since April 24, 2025
4419 W NORTH AVE, MELROSE PARK, IL 60160(773) 777-7112 Get Directions Write a Review

NPPES record last updated: April 24, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mitchell Kruckenberg Med, Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MITCHELL KRUCKENBERG MED, LPC (NPI 1184411712) is an individual mental health provider in Melrose Park, Illinois, licensed in Illinois (178.021554) and active in the NPI registry since April 2025.

NPPES Registry Identity

NPI1184411712
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameMITCHELL KRUCKENBERGCredential: MED, LPC
Location Address4419 W NORTH AVEMelrose Park, IL 60160-1021
Mailing Address4419 W North AveMelrose Park, IL 60160-1021
Phone(773) 777-7112
Sole ProprietorNo
Enumeration DateApril 24, 2025
NPPES CertifiedApril 24, 2025
✔ NPI 1184411712 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in IL · 178.021554
4419 W NORTH AVE, Melrose Park, IL 60160
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. AGNIESZKA ALINA WYSOCKA
Counselor (Professional)
4419 W NORTH AVE
MELROSE PARK, IL 60160
Cook County (773) 777-7112
LISA JEAN LEVY
Counselor
4419 W NORTH AVE
MELROSE PARK, IL 60160
Cook County (773) 777-7112
MISS ANDREA CELESTE PACHECO
Counselor
4419 W NORTH AVE
MELROSE PARK, IL 60160
Cook County (773) 777-7112
NOEL CORDOVA CADC, LPC
Counselor (Professional)
4419 W NORTH AVE
MELROSE PARK, IL 60160
Cook County (773) 777-7112
STEPHANIE ANN VERMILLION
Counselor (Professional)
4419 W NORTH AVE
MELROSE PARK, IL 60160
Cook County (773) 450-1798
ANGELES ELIZABETH VAZQUEZ
Counselor
4419 W NORTH AVE
MELROSE PARK, IL 60160
Cook County (773) 205-4587
MR. LAWRENCE WOZNICKI MS,CADC
Counselor (Addiction (Substance Use Disorder))
4419 W NORTH AVE
MELROSE PARK, IL 60160
Cook County (773) 777-7112
AMBER LYNN MAIBERGER BFA, RSA
Counselor
4419 W NORTH AVE
MELROSE PARK, IL 60160
Cook County (773) 777-7112

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mitchell Kruckenberg's NPI number?

The NPI number for Mitchell Kruckenberg is 1184411712. It was assigned to this individual provider in the NPPES registry on April 24, 2025.

Where is Mitchell Kruckenberg located?

Mitchell Kruckenberg practices at 4419 W North Ave, Melrose Park, IL 60160. The listed phone number is (773) 777-7112.

What is Mitchell Kruckenberg's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Mitchell Kruckenberg was last updated on April 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.