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General NPI Number Information
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NPI Number | 1427460377
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Entity Type | Organization
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Legal Business Name | KAREN CONNER, PH.D., LTD
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Dates
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Enumeration Date | 05/27/2014
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Last Update Date | 08/08/2014
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Provider Practice Location Address
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Address Line | 3139 N LINCOLN AVE SUITE 211
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City | CHICAGO
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State | IL
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Zip | 60657-3114
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Country | US
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Telephone | 773-868-0962
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Fax |
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Provider Business Mailing Address
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Address Line | 8861 N GRAND ST
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City | NILES
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State | IL
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Zip | 60714-1606
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Country | US
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Telephone | 773-868-0962
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KAREN CONNER
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Credential | PH.D.
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Telephone | 773-868-0962
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071005588
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License Number State | IL
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