Healthcare Provider Details

I. General information

NPI: 1386313229
Provider Name (Legal Business Name): KATHERINE NIMROD LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2021
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 N COLUMBUS DR UNIT 7403
CHICAGO IL
60601-5264
US

IV. Provider business mailing address

225 N COLUMBUS DR UNIT 7403
CHICAGO IL
60601-5264
US

V. Phone/Fax

Practice location:
  • Phone: 224-565-2627
  • Fax:
Mailing address:
  • Phone: 224-565-2627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number180.016046
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.016046
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: