| Doctor Name: | KERRI LYNN NEVIN |
| NPI Number: | 1114158508 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | 180.003984 |
| Business Practice Address: | 2201 Waukegan Rd Ste 145 Bannockburn, IL - 600151577 |
| Business Phone Number: | 8473741234 |
| Business Fax Number: | 8473741280 |
| Mailing Address: | 2201 Waukegan Rd Ste 145, BANNOCKBURN |
| State: | IL |
| Postal Code: | 600151577 |
| Phone Number: | 8473741234 |
| Fax Number: | 8473741280 |
| NPI Enumeration Date: | 08/03/2009 |
| NPI Last Update Date: | 08/03/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 180.003984 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |