MEDICARE: DR. NANCY A KUNKEL PSYD

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	103TC0700X	Clinical Psychologist	071-005295	IL

General Provider Information

NPI Number	:	1235292103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NANCY A KUNKEL PSYD

Provider Business Mailing Address
First Line	:	PO BOX 1192
Second Line	:
City	:	BARRINGTON
State	:	IL
Zip	:	60011-1192
Country	:	US
Telephone Number	:	630-446-0646
Fax Number	:

Provider Business Practice Location Address
First Line	:	2200 S MAIN ST STE 113
Second Line	:
City	:	LOMBARD
State	:	IL
Zip	:	60148-5364
Country	:	US
Telephone Number	:	630-209-0923
Fax Number	:

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

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	03/05/2026

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