Healthcare Provider Details

I. General information

NPI: 1861038200
Provider Name (Legal Business Name): EASE OF MIND PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2019
Last Update Date: 12/29/2020
Certification Date: 12/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10526 WEST CERMAK ROAD SUITE 308AA
WESTCHESTER IL
60154
US

IV. Provider business mailing address

10526 W CERMAK RD SUITE 308 AA
WESTCHESTER IL
60154
US

V. Phone/Fax

Practice location:
  • Phone: 312-502-8339
  • Fax:
Mailing address:
  • Phone: 312-502-8339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. KATHERINE CAMPBELL
Title or Position: CLINICAL PROFESSIONAL COUNSELOR/PSY
Credential: PHD, LCPC, NCSP
Phone: 312-502-8339