MEDICARE: KJL PSYCHOLOGICAL SERVICES PLLC

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1720936289
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KJL PSYCHOLOGICAL SERVICES PLLC

Provider Business Mailing Address
First Line	:	77 W WASHINGTON ST STE 1506
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60602-3220
Country	:	US
Telephone Number	:	312-248-9281
Fax Number	:

Provider Business Practice Location Address
First Line	:	77 W WASHINGTON ST STE 1506
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60602-3220
Country	:	US
Telephone Number	:	312-248-9281
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KIMBERLY J LANGREHR
Credential	:	PHD
Telephone Number	:	414-719-2441

Provider Enumeration Date	:	03/19/2026
Last Update Date	:	03/19/2026

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