Km Institute, Llc. | |
1444 N Farnsworth Ave Ste 304 Aurora IL 60505-1642 | |
(331) 213-9706 | |
Not Available |
Full Name | Km Institute, Llc. |
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Speciality | Counselor |
Location | 1444 N Farnsworth Ave Ste 304, Aurora, Illinois |
Authorized Official Name and Position | Kristy Camille-mckiness (CEO) |
Authorized Official Contact | 3312139706 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Km Institute, Llc. 1444 N Farnsworth Ave Ste 304 Aurora IL 60505-1642 Ph: (331) 213-9706 | Km Institute, Llc. 1444 N Farnsworth Ave Ste 304 Aurora IL 60505-1642 Ph: (331) 213-9706 |
NPI Number | 1184013930 |
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Provider Enumeration Date | 01/16/2015 |
Last Update Date | 02/08/2023 |
Certification Date | 02/08/2023 |
Medicare PECOS PAC ID | 0648603845 |
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Medicare Enrollment ID | O20191202001061 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184013930 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 180.007038 (Illinois) | Primary |
Provider Name | Jennifer R Baltazar |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1265990238 PECOS PAC ID: 8729411954 Enrollment ID: I20191202002578 |
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