| Kristine Olivas | |
|
10725 S Western Ave Chicago IL 60643-3135 | |
| (773) 957-5352 | |
| (773) 253-9551 |
| Full Name | Kristine Olivas |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 10725 S Western Ave, Chicago, Illinois |
| Authorized Official Name and Position | Kristine Olivas (OWNER) |
| Authorized Official Contact | 7739575352 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kristine Olivas 11164 S Saint Louis Ave Chicago IL 60655-3521 Ph: (773) 253-9551 | Kristine Olivas 10725 S Western Ave Chicago IL 60643-3135 Ph: (773) 957-5352 |
| NPI Number | 1013154129 |
|---|---|
| Provider Enumeration Date | 01/12/2009 |
| Last Update Date | 03/10/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013154129 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 166.000734 (Illinois) | Primary |
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