Healthcare Provider Details

I. General information

NPI: 1457654626
Provider Name (Legal Business Name): SYLVIA K KYOBE PSYCHOLOGIST PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2010
Last Update Date: 04/29/2022
Certification Date: 04/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 W HOWARD ST # 102
CHICAGO IL
60645-2113
US

IV. Provider business mailing address

2045 W HOWARD ST # 102
CHICAGO IL
60645-2113
US

V. Phone/Fax

Practice location:
  • Phone: 224-766-0758
  • Fax:
Mailing address:
  • Phone: 224-766-0758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: