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General NPI Number Information
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NPI Number | 1730327263
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Entity Type | Organization
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Legal Business Name | KATHERINE UPHOFF, PH.D. S.C.
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Dates
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Enumeration Date | 01/21/2009
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Last Update Date | 01/21/2009
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Provider Practice Location Address
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Address Line | 35 E WACKER DR STE, 1350
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City | CHICAGO
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State | IL
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Zip | 60601-2314
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Country | US
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Telephone | 312-553-0793
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Fax | 312-553-4213
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Provider Business Mailing Address
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Address Line | 35 E WACKER DR STE, 1350
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City | CHICAGO
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State | IL
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Zip | 60601-2314
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Country | US
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Telephone | 312-553-0793
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Fax | 312-553-4213
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KATHERINE ANNE UPHOFF
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Credential | PH.D.
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Telephone | 312-553-0793
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 071-004332
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License Number State | IL
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