Cameron, Kristan

Cameron, Kristan is an individual health care provider with primary practice located at 800 Main St , Antioch IL 60002-1542. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Cameron, Kristan can be contacted via phone (847) 838-9904.

Contact Information

Primary practice address
800 Main St Antioch IL 60002-1542
Phone: (847) 838-9904
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X Illinois

Profile Details

NPI number 1457579625
LBN Legal business name Cameron, Kristan
Credentials MA., LCPC
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 23rd, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457579625 NPPES
Illinois Other 04932457 BCBS GROUP #
Illinois Other 1801808696 BCBS GROUP #

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