Kathie Benson, PSY.D.

Individual provider Active NPI Clinical Psychologist · Niles, IL

NPI 1104084524 · NPPES record last updated Jun 2, 2008

Key facts

NPI
1104084524
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
071004742 (IL)
Practice address
6289 W Howard St
Niles, IL 60714-3403
Phone
(847) 588-0463
Fax
(847) 588-0464
NPI assigned
Jun 2, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
071004742ILMDClinical Psychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071004742 IL Yes

Addresses

Primary practice location

6289 W Howard St
Niles, IL 60714-3403

Mailing address

6289 W Howard St
Niles, IL 60714-3403
Phone (847) 588-0463

Other providers in Niles, IL

All providers in Niles, IL · Clinical Psychologist in Illinois

Sources for this page

Verify at the official NPI Registry.