Basic Information
| Provider Information | |||||||||
| NPI: | 1093115024 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KALLMANN COUNSELING AND CONSULTING, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2530 CRAWFORD AVE | ||||||||
| Address2: | SUITE 208 | ||||||||
| City: | EVANSTON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 602014970 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2246882277 | ||||||||
| FaxNumber: | 8889771505 | ||||||||
| Practice Location | |||||||||
| Address1: | 2530 CRAWFORD AVE | ||||||||
| Address2: | SUITE 208 | ||||||||
| City: | EVANSTON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 602014970 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2246882277 | ||||||||
| FaxNumber: | 8889771505 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/27/2014 | ||||||||
| LastUpdateDate: | 08/27/2014 | ||||||||
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| AuthorizedOfficialLastName: | KALLMANN SPIEGEL | ||||||||
| AuthorizedOfficialFirstName: | KIMBERLY | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER/THERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 2246882277 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | LCPC, CADC, CSAT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 180.007275 | IL | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.