Doctor Name: | KATHRYN S. KIRK |
NPI Number: | 1053708255 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 180008819 |
Business Practice Address: | 1100 Landmeier Rd #202 Elk Grove Village, IL - 600072419 |
Business Phone Number: | 8473436338 |
Business Fax Number: | |
Mailing Address: | 1100 Landmeier Rd, #202 ELK GROVE VILLAGE |
State: | IL |
Postal Code: | 600072419 |
Phone Number: | 8473436338 |
Fax Number: | |
NPI Enumeration Date: | 04/25/2015 |
NPI Last Update Date: | 04/26/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 180008819 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |