| Kathy Abbott Psyd Pc | |
|
3317 W 95th St Ste 205 Evergreen Park IL 60805 | |
| (773) 807-0936 | |
| (773) 247-0507 |
| Full Name | Kathy Abbott Psyd Pc |
|---|---|
| Speciality | Psychologist |
| Location | 3317 W 95th St, Evergreen Park, Illinois |
| Authorized Official Name and Position | Kathy Dana Abbott (PRESIDENT) |
| Authorized Official Contact | 7738070936 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kathy Abbott Psyd Pc 3317 W 95th St Ste 205 Evergreen Park IL 60805 Ph: (773) 807-0936 | Kathy Abbott Psyd Pc 3317 W 95th St Ste 205 Evergreen Park IL 60805 Ph: (773) 807-0936 |
| NPI Number | 1326113838 |
|---|---|
| Provider Enumeration Date | 11/21/2006 |
| Last Update Date | 03/13/2008 |
| Medicare PECOS PAC ID | 2668464165 |
|---|---|
| Medicare Enrollment ID | O20040402000729 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326113838 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | (Illinois) | Primary |
| Provider Name | Kathy D Abbott |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922188929 PECOS PAC ID: 1951205236 Enrollment ID: I20031120000176 |
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