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General NPI Number Information
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NPI Number | 1548446859
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Entity Type | Organization
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Legal Business Name | KEVIN AND ASSOC INC
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Dates
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Enumeration Date | 01/16/2008
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Last Update Date | 01/16/2008
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Provider Practice Location Address
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Address Line | 257 N WEST AVE 205
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City | ELMHURST
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State | IL
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Zip | 60126
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Country | US
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Telephone | 630-941-8270
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Fax | 630-941-8294
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Provider Business Mailing Address
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Address Line | 257 N WEST AVE 205
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City | ELMHURST
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State | IL
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Zip | 60126
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Country | US
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Telephone | 630-941-8270
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Fax | 630-941-8294
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MAUREEN H KEVIN
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Credential | LCSW
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Telephone | 630-941-8270
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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 |
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | IL
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