MEDICARE: DR. KATHLEEN J SEXTON-RADEK PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	071005336	IL
2	103TC0700X	Clinical Psychologist	071005336	IL

General Provider Information

NPI Number	:	1336152602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHLEEN J SEXTON-RADEK PHD

Provider Business Mailing Address
First Line	:	700 E OGDEN AVE
Second Line	:	SUITE 202
City	:	WESTMONT
State	:	IL
Zip	:	60559-5569
Country	:	US
Telephone Number	:	630-789-9785
Fax Number	:	630-789-9798

Provider Business Practice Location Address
First Line	:	700 E OGDEN AVE
Second Line	:	SUITE 202
City	:	WESTMONT
State	:	IL
Zip	:	60559-5569
Country	:	US
Telephone Number	:	630-789-9785
Fax Number	:	630-789-9798

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	08/21/2009

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Directions to “ DR. KATHLEEN J SEXTON-RADEK PHD” Practice Location

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