Healthcare Provider Details

I. General information

NPI: 1609637925
Provider Name (Legal Business Name): K.A.M ALLIANCE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2024
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 N GREENLEAF ST STE 228
GURNEE IL
60031-3371
US

IV. Provider business mailing address

2215 W 95TH ST # 100
CHICAGO IL
60643-1001
US

V. Phone/Fax

Practice location:
  • Phone: 847-201-4070
  • Fax: 773-239-9601
Mailing address:
  • Phone: 773-239-9600
  • Fax: 773-239-9601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANGELA J RATCLIFFE
Title or Position: ADMINISTRATOR
Credential:
Phone: 773-239-9600