Healthcare Provider Details

I. General information

NPI: 1568391068
Provider Name (Legal Business Name): KATHLEEN ELIZABETH EGGERT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1006 S OAK PARK AVE
OAK PARK IL
60304-1925
US

IV. Provider business mailing address

1006 S OAK PARK AVE
OAK PARK IL
60304-1925
US

V. Phone/Fax

Practice location:
  • Phone: 708-334-4321
  • Fax:
Mailing address:
  • Phone: 708-334-4321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number178009429
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: