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General NPI Number Information
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NPI Number | 1891894812
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Entity Type | Individual
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Provider Name | KATHLEEN A KAPP-SIMON PH.D.
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Gender | Female
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 01/18/2013
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Provider Practice Location Address
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Address Line | 2211 N. OAK PARK AVE SHRINERS HOSPITALS FOR CHILDREN CHICAGO
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City | CHICAGO
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State | IL
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Zip | 60707
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Country | US
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Telephone | 773-385-5407
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Fax | 773-385-5830
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Provider Business Mailing Address
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Address Line | SHRINERS HOSPITAL FOR CHILDREN CHICAGO P. O. BOX 8500, LOCKBOX 7642
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City | PHILADELPHIA
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State | PA
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Zip | 19178-7642
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Country | US
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Telephone | 813-281-8115
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Fax | 813-281-8656
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 071 002924
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License Number State | IL
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