Healthcare Provider Details

I. General information

NPI: 1417747817
Provider Name (Legal Business Name): RILEY KLINK PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2025
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 N RIVER ST STE 210
BATAVIA IL
60510-2386
US

IV. Provider business mailing address

109 N CAROLINE ST
CRYSTAL LAKE IL
60014-4345
US

V. Phone/Fax

Practice location:
  • Phone: 630-732-0404
  • Fax:
Mailing address:
  • Phone: 630-732-0404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071011447
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: