Michelle Kukla PSYD PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071006865 Issued in IL

Legal business name

MICHELLE KUKLA PSYD PC

Practice address

800 E Northwest Hwy Ste 500
Palatine, IL 60074-6511

Phone

(708) 560-6653

NPI assigned

Sep 13, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Michelle Kukla, PSYDNPI 1457383648

Title

Owner

Phone

(708) 560-6653

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michelle Ann Kukla, PSYD

  • Clinical Psychologist
  • Schaumburg, IL
  • NPI 1457383648
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347494400000",
    "number": "1225388697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E NORTHWEST HWY STE 500",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600746511",
            "telephone_number": "708-560-6653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E NORTHWEST HWY STE 500",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600746511",
            "telephone_number": "708-560-6653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELLE KUKLA PSYD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-13",
        "last_updated": "2012-09-13",
        "status": "A",
        "authorized_official_last_name": "KUKLA",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-560-6653",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071006865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Meyers
• MH Health Care Services, PC
• Michael P. Kennedy, LLC
• Michelle Delarosa Therapy, LCPC, LLC
• Michelle Gonzales LLC
• Emma Mikan
• Victoria Ann Mikos, MS, CCC-SLP
• Miller Therapy LLC
• Douglas Miller
• Scott Andrew Miller, PHARMD

• Clinical Psychologist in Palatine, IL
• Providers in Palatine, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.