MEDICARE: KIMBERLY KAY MORRISON

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	101YP2500X	Professional Counselor	178019347	IL

General Provider Information

NPI Number	:	1982483145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY KAY MORRISON

Provider Business Mailing Address
First Line	:	1870 N BURLING ST APT 1
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-5104
Country	:	US
Telephone Number	:	330-715-5770
Fax Number	:

Provider Business Practice Location Address
First Line	:	180 N MICHIGAN AVE STE 1025C
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60601-7999
Country	:	US
Telephone Number	:	330-715-5770
Fax Number	:

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

Provider Enumeration Date	:	09/27/2023
Last Update Date	:	09/27/2023

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Directions to “ KIMBERLY KAY MORRISON ” Practice Location

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