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NPI Code Detail

MEDICARE: KARIN KENDRICK

MEDICARE: KARIN KENDRICK
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
1106S00000XBehavior TechnicianIL

General Provider Information

NPI Number : 1306117361
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARIN KENDRICK
Provider Business Mailing Address
First Line : 18300 S. HALSTED STREET
Second Line : STE B MB 114
City : GLENWOOD
State : IL
Zip : 60425
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 737 W WRIGHTWOOD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60614-2539
Country : US
Telephone Number : 773-672-9815
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2012
Last Update Date : 01/09/2024

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