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General NPI Number Information
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NPI Number | 1073787354
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Entity Type | Individual
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Provider Name | KATHI LEA KAMM PHD
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Gender | Female
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Dates
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Enumeration Date | 04/17/2008
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Last Update Date | 04/17/2008
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Provider Practice Location Address
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Address Line | 5225 OLD ORCHARD ROAD SUITE 18
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City | SKOKIE
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State | IL
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Zip | 60076
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Country | US
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Telephone | 847-663-1020
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Fax |
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Provider Business Mailing Address
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Address Line | 5818 N AMES TER
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City | GLENDALE
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State | WI
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Zip | 53209-4344
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Country | US
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Telephone | 414-243-3454
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Fax |
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State | IL
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