Kandi M Fowler, CADC,MISA1,CAMS11

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

25385 Issued in IL

Practice address

721 N. Lasalle St.
2601 W. Marquette Rd
Chicago, IL 60629

Phone

(773) 349-8050

Fax

(773) 349-8080

NPI assigned

Aug 28, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472342400000",
    "number": "1174079313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 N. LASALLE",
            "address_2": "721 N. LASALLE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60654",
            "telephone_number": "773-349-8050",
            "fax_number": "773-349-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 N. LASALLE ST.",
            "address_2": "2601 W. MARQUETTE RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60629",
            "telephone_number": "773-349-8050",
            "fax_number": "773-349-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "KANDI",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "CADC,MISA1,CAMS11",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-28",
        "last_updated": "2016-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "25385",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "25385",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beverly Fowler
• Brenda Fowler, CNM
• Bridget Fowler, PT, DPT
• Edwaed Weldon Fowler, PAC
• Jasmine Ashley Fowler, APRN
• Kelley Fowler, BCBA
• Krystal M Fowler, LCPC; LPC
• Michelle Ann Fowler, CRNA
• Nadja Fowler, M.ED., LCPC
• Nancy Christine Fowler, APRN, BC, CNP

• Addiction (Substance Use Disorder) Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Addiction (Substance Use Disorder) Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.