| Km Institute, Llc. | |
|
1444 N Farnsworth Ave Ste 304 Aurora IL 60505-1642 | |
| (331) 213-9706 | |
| Not Available |
| Full Name | Km Institute, Llc. |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 01/16/2015 |
| Last Update Date | 02/08/2023 |
| Certification Date | 02/08/2023 |
| Medicare PECOS PAC ID | 0648603845 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265990238 PECOS PAC ID: 8729411954 Enrollment ID: I20191202002578 |
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