Healthcare Provider Details

I. General information

NPI: 1780531665
Provider Name (Legal Business Name): ALI KERN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 E MAIN ST
WEST FRANKFORT IL
62896-2406
US

IV. Provider business mailing address

1606 N GARFIELD ST
MARION IL
62959-3356
US

V. Phone/Fax

Practice location:
  • Phone: 618-217-0567
  • 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:
Title or Position:
Credential:
Phone: