| Kimberly M Rothwell | |
|
460 N Main St Suite 302 Glen Ellyn IL 60137-5176 | |
| (312) 968-3154 | |
| Not Available |
| Full Name | Kimberly M Rothwell |
|---|---|
| Speciality | Counselor - Professional |
| Location | 460 N Main St, Glen Ellyn, Illinois |
| Authorized Official Name and Position | Kimberly Rothwell (DANCE/MOVEMENT THERAPIST) |
| Authorized Official Contact | 3129683154 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kimberly M Rothwell 838 Hill Ave Glen Ellyn IL 60137-5207 Ph: () - | Kimberly M Rothwell 460 N Main St Suite 302 Glen Ellyn IL 60137-5176 Ph: (312) 968-3154 |
| NPI Number | 1962830786 |
|---|---|
| Provider Enumeration Date | 10/15/2013 |
| Last Update Date | 02/07/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962830786 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 28374 (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | 180.007496 (Illinois) | Primary |
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