MEDICARE: DR. KATHLEEN CHECK PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	180-005374	IL
2	101YM0800X	Mental Health Counselor	39003527A	IN
3	101YP2500X	Professional Counselor	180-005374	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0001635069	OTHER	IL	BCBS OF ILLINOIS

General Provider Information

NPI Number	:	1033249107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHLEEN CHECK PHD

Provider Business Mailing Address
First Line	:	405 N WABASH AVE UNIT 1815
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-5661
Country	:	US
Telephone Number	:	312-560-9375
Fax Number	:

Provider Business Practice Location Address
First Line	:	405 N WABASH AVE UNIT 1815
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-5661
Country	:	US
Telephone Number	:	312-560-9375
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	12/29/2022

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Directions to “ DR. KATHLEEN CHECK PHD” Practice Location

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