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General NPI Number Information
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NPI Number | 1023802030
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Entity Type | Organization
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Legal Business Name | KALYN LANTZ PLLC
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Dates
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Enumeration Date | 04/07/2025
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 5514 W LAWRENCE AVE STE A
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City | CHICAGO
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State | IL
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Zip | 60630-3412
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Country | US
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Telephone | 872-248-4344
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Fax |
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Provider Business Mailing Address
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Address Line | 5514 W LAWRENCE AVE STE A
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City | CHICAGO
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State | IL
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Zip | 60630-3412
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Country | US
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Telephone | 872-248-4344
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CAROLYN NEVAREZ
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Credential |
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Telephone | 312-248-4091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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