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General NPI Number Information
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NPI Number | 1154820108
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Entity Type | Individual
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Provider Name | KALEN NICOLE COBB
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Gender | Female
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Dates
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Enumeration Date | 02/05/2018
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Last Update Date | 06/21/2023
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Provider Practice Location Address
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Address Line | 1550 S INDIANA AVE STE 2E
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City | CHICAGO
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State | IL
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Zip | 60605-2857
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Country | US
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Telephone | 773-377-5577
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Fax |
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Provider Business Mailing Address
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Address Line | 5955 N WINTHROP AVE APT 1W
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City | CHICAGO
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State | IL
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Zip | 60660-3535
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Country | US
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Telephone | 857-399-2315
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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