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NPI Code Detail

MEDICARE: MS. KELLIE RICE PSY. D., LCPC, CGP

MEDICARE: MS. KELLIE RICE PSY. D., LCPC, CGP
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
1101YA0400XAddiction (Substance Use Disorder) Counselor180007294IL
2101YP2500XProfessional Counselor180.007294IL
3103TP2701XGroup Psychotherapy Psychologist180007294IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1180007294OTHERILLCPC

General Provider Information

NPI Number : 1891002242
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KELLIE RICE PSY. D., LCPC, CGP
Provider Business Mailing Address
First Line : 3209 N LAKEWOOD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60657-3215
Country : US
Telephone Number : 312-279-9981
Fax Number : 866-671-9991
Provider Business Practice Location Address
First Line : 30 N MICHIGAN AVE STE 424
Second Line :
City : CHICAGO
State : IL
Zip : 60602-3844
Country : US
Telephone Number : 312-279-9981
Fax Number : 312-279-9981
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2010
Last Update Date : 12/11/2025

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