Basic Information
| Provider Information | |||||||||
| NPI: | 1467572610 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HABEL | ||||||||
| FirstName: | KIM | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | PSY.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 210 W. 22ND ST. | ||||||||
| Address2: | SUITE 119 | ||||||||
| City: | OAK BROOK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60523 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6305715716 | ||||||||
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| Practice Location | |||||||||
| Address1: | 210 W 22ND ST | ||||||||
| Address2: | SUITE 119 | ||||||||
| City: | OAK BROOK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605231544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6305715716 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2007 | ||||||||
| LastUpdateDate: | 10/22/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 071.007504 | IL | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.