Healthcare Provider Details

I. General information

NPI: 1619274875
Provider Name (Legal Business Name): JAMEE S KERKMAN LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JAMEE S ADKINS LCPC

II. Dates (important events)

Enumeration Date: 02/23/2011
Last Update Date: 03/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 W WASHINGTON ST SUITE 220
OSWEGO IL
60543-8214
US

IV. Provider business mailing address

PO BOX 841
OSWEGO IL
60543-0841
US

V. Phone/Fax

Practice location:
  • Phone: 630-204-1101
  • Fax: 630-618-3667
Mailing address:
  • Phone: 630-204-1101
  • Fax: 630-618-3667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180008412
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180008412
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: