Healthcare Provider Details

I. General information

NPI: 1366658999
Provider Name (Legal Business Name): KALLI NICOLE RIMIKIS-KERR LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 03/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

THREE FIRST NATIONAL PLAZA, 70 WEST MADISON STREET SUITE 650
CHICAGO IL
60602
US

IV. Provider business mailing address

165 W GOETHE ST
CHICAGO IL
60610-1914
US

V. Phone/Fax

Practice location:
  • Phone: 312-933-8785
  • Fax: 312-236-9157
Mailing address:
  • Phone: 312-933-8785
  • Fax: 312-236-9157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number166.000825
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: