Healthcare Provider Details

I. General information

NPI: 1023898822
Provider Name (Legal Business Name): CAROLINA KUHL LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2023
Last Update Date: 09/29/2023
Certification Date: 09/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2732 N CLARK ST
CHICAGO IL
60614-6073
US

IV. Provider business mailing address

2632 S SPAULDING AVE
CHICAGO IL
60623-4744
US

V. Phone/Fax

Practice location:
  • Phone: 773-250-1769
  • Fax:
Mailing address:
  • Phone: 773-300-7639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150111740
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: