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General NPI Number Information
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NPI Number | 1326270729
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Entity Type | Individual
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Provider Name | KATHLEEN KARDARAS PSY.D., LCPC, MHT
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Gender | Female
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Dates
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Enumeration Date | 08/18/2009
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Last Update Date | 08/18/2009
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Provider Practice Location Address
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Address Line | 4741 N KNOX AVE
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City | CHICAGO
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State | IL
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Zip | 60630-4031
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Country | US
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Telephone | 773-777-4003
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Fax | 847-673-8802
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Provider Business Mailing Address
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Address Line | 4741 N KNOX AVE
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City | CHICAGO
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State | IL
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Zip | 60630-4031
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Country | US
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Telephone | 773-777-4003
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Fax | 847-673-8802
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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 | 180003234
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License Number State | IL
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