Basic Information
| Provider Information | |||||||||
| NPI: | 1972934271 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KALLMANN COUNSELING & CONSULTING PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2530 CRAWFORD AVE | ||||||||
| Address2: | SUITE 208 | ||||||||
| City: | EVANSTON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 602014970 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2246882277 | ||||||||
| FaxNumber: | 7737512250 | ||||||||
| Practice Location | |||||||||
| Address1: | 2530 CRAWFORD AVE | ||||||||
| Address2: | SUITE 208 | ||||||||
| City: | EVANSTON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 602014970 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2246882277 | ||||||||
| FaxNumber: | 7737512250 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2013 | ||||||||
| LastUpdateDate: | 12/11/2013 | ||||||||
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| AuthorizedOfficialLastName: | KALLMANN | ||||||||
| AuthorizedOfficialFirstName: | KIMBERLY | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2246882277 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LCPC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 180007275 | IL | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.