Healthcare Provider Details

I. General information

NPI: 1639036643
Provider Name (Legal Business Name): KPM THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 09/06/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 TRI STATE INTL STE 250
LINCOLNSHIRE IL
60069-4427
US

IV. Provider business mailing address

810 HIGHLAND PL
HIGHLAND PARK IL
60035-4803
US

V. Phone/Fax

Practice location:
  • Phone: 847-828-0359
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: KRISTIN PLATH
Title or Position: OWNER/THERAPIST
Credential: LCPC
Phone: 847-828-0359