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General NPI Number Information
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NPI Number | 1568850881
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Entity Type | Individual
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Provider Name | MS. KATHRYN A PUSATERI
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Gender | Female
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Dates
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Enumeration Date | 01/09/2015
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Last Update Date | 01/09/2015
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Provider Practice Location Address
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Address Line | 6554 NORTH ROCKWELL STREET SUITE 2
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City | CHICAGO
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State | IL
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Zip | 60645
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Country | US
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Telephone | 773-467-7948
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Fax |
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Provider Business Mailing Address
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Address Line | 6551 N MAPLEWOOD AVE
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City | CHICAGO
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State | IL
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Zip | 60645-5317
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Country | US
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Telephone | 773-456-6581
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180.008836
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License Number State | IL
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