Healthcare Provider Details

I. General information

NPI: 1629491394
Provider Name (Legal Business Name): KATE GIANDONATO & ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2014
Last Update Date: 01/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 LAKE ST SUITE 201
OAK PARK IL
60301-1015
US

IV. Provider business mailing address

1100 LAKE ST SUITE 201
OAK PARK IL
60301-1015
US

V. Phone/Fax

Practice location:
  • Phone: 773-766-7010
  • Fax: 708-970-8097
Mailing address:
  • Phone: 773-766-7010
  • Fax: 708-970-8097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.012998
License Number StateIL

VIII. Authorized Official

Name: KATHLEEN A GIANDONATO
Title or Position: BUSINESS OWNER
Credential:
Phone: 773-766-7010