Healthcare Provider Details

I. General information

NPI: 1992307250
Provider Name (Legal Business Name): KERRI HONEYWOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2020
Last Update Date: 06/07/2021
Certification Date: 06/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7610 S ESSEX AVE
CHICAGO IL
60649-4184
US

IV. Provider business mailing address

1 E ERIE ST STE 525 PMB 4099
CHICAGO IL
60611
US

V. Phone/Fax

Practice location:
  • Phone: 773-234-2260
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: