1275685380 NPI number — KREMPP PSYCHOLOGICAL SERVICES, P.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275685380 NPI number — KREMPP PSYCHOLOGICAL SERVICES, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KREMPP PSYCHOLOGICAL SERVICES, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275685380
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13300 S ROUTE 59
Provider Second Line Business Mailing Address:
C4
Provider Business Mailing Address City Name:
PLAINFIELD
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60585-9847
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
815-577-0278
Provider Business Mailing Address Fax Number:
815-577-6292

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13300 S ROUTE 59
Provider Second Line Business Practice Location Address:
C4
Provider Business Practice Location Address City Name:
PLAINFIELD
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60585-9847
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
815-577-0278
Provider Business Practice Location Address Fax Number:
815-577-6292
Provider Enumeration Date:
01/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KREMPP
Authorized Official First Name:
CLAUDIA
Authorized Official Middle Name:
MARIA
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
815-577-0278

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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