Doctor Name: | DR. STEVEN DOUGLAS KULB |
NPI Number: | 1265568224 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSY.D. |
License Number: | |
Business Practice Address: | 420 West Grand Avenue Lake Villa, IL - 60046 |
Business Phone Number: | 8473563322 |
Business Fax Number: | 8473562360 |
Mailing Address: | 1316 Madison St, EVANSTON |
State: | IL |
Postal Code: | 602022137 |
Phone Number: | 8478696620 |
Fax Number: | |
NPI Enumeration Date: | 02/26/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |