Healthcare Provider Details

I. General information

NPI: 1770878787
Provider Name (Legal Business Name): KATHERINE LIK ND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2011
Last Update Date: 06/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N MICHIGAN AVE SUITE 450
CHICAGO IL
60611-3777
US

IV. Provider business mailing address

500 N. MICHIGAN AVENUE SUITE 450
CHICAGO IL
60611
US

V. Phone/Fax

Practice location:
  • Phone: 312-276-1212
  • Fax:
Mailing address:
  • Phone: 312-276-1212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND270
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: