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General NPI Number Information
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NPI Number | 1033757349
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Entity Type | Individual
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Provider Name | ARIANNA TIMKO PSYD
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Gender | Female
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Dates
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Enumeration Date | 12/17/2019
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Last Update Date | 01/13/2020
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Provider Practice Location Address
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Address Line | 6501 S PROMONTORY DR
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City | CHICAGO
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State | IL
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Zip | 60649-1002
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Country | US
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Telephone | 773-256-5723
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Fax | 773-363-7664
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Provider Business Mailing Address
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Address Line | 6501 S PROMONTORY DRIVE C/O BEHAVIORAL HEALTH DEPARTMENT
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City | CHICAGO
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State | IL
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Zip | 60649
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Country | US
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Telephone | 773-256-5723
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Fax | 773-363-7664
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071.010221
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License Number State | IL
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