Healthcare Provider Details

I. General information

NPI: 1164083325
Provider Name (Legal Business Name): KASEY LYNN KRAMER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2019
Last Update Date: 06/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 THOREAU DR N STE 180
SCHAUMBURG IL
60173-4151
US

IV. Provider business mailing address

1920 THOREAU DR N STE 180
SCHAUMBURG IL
60173-4151
US

V. Phone/Fax

Practice location:
  • Phone: 847-496-5513
  • Fax:
Mailing address:
  • Phone: 847-496-5513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-19-36834
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: