1295741734 NPI number — MR. DANIEL J KILL LCSW

Table of content: MR. DANIEL J KILL LCSW (NPI 1295741734)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295741734 NPI number — MR. DANIEL J KILL LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KILL
Provider First Name:
DANIEL
Provider Middle Name:
J
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1295741734
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/02/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1506 FOREST RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LA GRANGE PARK
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60526-1125
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
708-261-7423
Provider Business Mailing Address Fax Number:
888-601-0184

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1101 LAKE ST
Provider Second Line Business Practice Location Address:
SUITE 405 H
Provider Business Practice Location Address City Name:
OAK PARK
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60301-1085
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-432-6805
Provider Business Practice Location Address Fax Number:
888-601-0184
Provider Enumeration Date:
08/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  149001918 , 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)

  • Identifier: IL4144 . This is a "AETNA BETTER HEALTH" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: P008648 . This is a "INTEGRATED INSIGHTS/HHRC" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 01627100 . This is a "BLUE CROSS BLUE SHIELD IL" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 2229271 . This is a "COMPSYCH" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 82307 . This is a "FIRST HEALTH/COVENTRY" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 088366 . This is a "MHN" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 2235893 . This is a "CIGNA" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 5651644 . This is a "AETNA" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 79924 . This is a "HFN" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 219851757 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: KILDANI . This is a "LIFESYNC/HUMANA" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: M008648 . This is a "HORIZON" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 099093000 . This is a "MAGELLAN BEHAVIORAL HEALT" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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