Healthcare Provider Details

I. General information

NPI: 1043146236
Provider Name (Legal Business Name): CATHERINE EVE KLEINMUNTZ PHD, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4707 N BROADWAY ST STE 200
CHICAGO IL
60640-4999
US

IV. Provider business mailing address

4707 N BROADWAY ST STE 200
CHICAGO IL
60640-4999
US

V. Phone/Fax

Practice location:
  • Phone: 312-210-0393
  • Fax:
Mailing address:
  • Phone: 312-210-0393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150.129324
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: