Healthcare Provider Details

I. General information

NPI: 1447474473
Provider Name (Legal Business Name): KATHERINE ANNE BILLINGHAM PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 N MICHIGAN AVE SUITE 1750
CHICAGO IL
60611-3110
US

IV. Provider business mailing address

300 DOWNING RD
RIVERSIDE IL
60546-1735
US

V. Phone/Fax

Practice location:
  • Phone: 312-822-0705
  • Fax:
Mailing address:
  • Phone: 312-822-0705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number7100002469
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateIL
# 5
Primary TaxonomyY
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number7100002469
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: