| Doctor Name: | KATE KANICHIRAYIL |
| NPI Number: | 1093912073 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.C.S.W. |
| License Number: | 149012065 |
| Business Practice Address: | 3001 Green Bay Rd North Chicago, IL - 600643048 |
| Business Phone Number: | 2246104223 |
| Business Fax Number: | |
| Mailing Address: | 2552 W Rosemont Ave, Apt. 3 CHICAGO |
| State: | IL |
| Postal Code: | 606591872 |
| Phone Number: | 7738563731 |
| Fax Number: | |
| NPI Enumeration Date: | 07/02/2007 |
| NPI Last Update Date: | 07/29/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 149012065 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |