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General NPI Number Information
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NPI Number | 1194240705
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Entity Type | Organization
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Legal Business Name | KATHARINE KHARAS PSYD, INC.
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Dates
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Enumeration Date | 08/04/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 25 EAST WASHINGTON STREET SUITE 908
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City | CHICAGO
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State | IL
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Zip | 60602-1718
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Country | US
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Telephone | 773-330-5688
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Fax |
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Provider Business Mailing Address
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Address Line | 25 E WASHINGTON ST STE 908
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City | CHICAGO
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State | IL
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Zip | 60602-1718
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Country | US
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Telephone | 773-330-5688
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. KATHARINE ELIZABETH KHARAS
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Credential | PSYD
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Telephone | 773-330-5688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 071.009179
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License Number State | IL
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