Provider Demographics
NPI:1689476491
Name:FRACZEK, JULIA CATHERINE (MM, LPMT, MT-BC)
Entity type:Individual
Prefix:MISS
First Name:JULIA
Middle Name:CATHERINE
Last Name:FRACZEK
Suffix:
Gender:
Credentials:MM, LPMT, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 E OGDEN AVE UNIT 432
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:IL
Mailing Address - Zip Code:60525-2181
Mailing Address - Country:US
Mailing Address - Phone:734-624-5573
Mailing Address - Fax:
Practice Address - Street 1:250 WATER STONE CIR
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60431-8313
Practice Address - Country:US
Practice Address - Phone:815-740-4104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
16314225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist