KC Eating Disorder Clinic PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

KC EATING DISORDER CLINIC PLLC

Practice address

313 N Mattis Ave Ste 110
Champaign, IL 61821-7901

Phone

(217) 377-0299

NPI assigned

Aug 27, 2025

Organization subpart

No

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

Authorized official

Name

Kaitlyn Cornell, LCSW, CEDS-S

Title

Ceo

Phone

(217) 621-0766

Specialties & licenses 2

Addresses

Tax ID family

KC Eating Disorder Clinic PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• KC Eating Disorder Clinic PLLC

  • Clinic/Center
  • Champaign, IL
  • NPI 1326927971
  NPD tax ID

Locations

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

{
    "created_epoch": "1756252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756252800000",
    "number": "1740169655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 FLORA DR",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618213212",
            "telephone_number": "217-621-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 N MATTIS AVE STE 110",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618217901",
            "telephone_number": "217-377-0299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KC EATING DISORDER CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-27",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A",
        "authorized_official_last_name": "CORNELL",
        "authorized_official_first_name": "KAITLYN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "217-621-0766",
        "authorized_official_credential": "LCSW, CEDS-S"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erick Makio Kawakita, M.D.
• Susan Kazmierczak, MSW, LCSW
• KC Counseling, LLC
• KC Counseling, LLC
• KC Eating Disorder Clinic PLLC
• Rhona Ke, MD
• Maura Christine Kealy, ATC
• April L Keaton, LCSW
• Joseph J Keeley, MD
• Jessica Keen, HIM

• Mental Health Clinic/Center (Including Community Mental Health Center) in Champaign, IL
• Providers in Champaign, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; 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.