MEDICARE: KIMBERLY A CURTIS LCPC

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	101Y00000X	Counselor	178.016303	IL
2	101YP2500X	Professional Counselor	180.0016631	IL

General Provider Information

NPI Number	:	1982211702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY A CURTIS LCPC

Provider Business Mailing Address
First Line	:	1616 N DAMEN AVE STE 301
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-5536
Country	:	US
Telephone Number	:	888-428-7890
Fax Number	:	888-428-7891

Provider Business Practice Location Address
First Line	:	1616 N DAMEN AVE STE 301
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-5536
Country	:	US
Telephone Number	:	888-428-7890
Fax Number	:	888-428-7891

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

Provider Enumeration Date	:	09/25/2020
Last Update Date	:	01/06/2025

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Directions to “ KIMBERLY A CURTIS LCPC” Practice Location

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