| Michelle Kukla Psyd Pc | |
|
800 E Northwest Hwy Ste 500 Palatine IL 60074-6511 | |
| (708) 560-6653 | |
| Not Available |
| Full Name | Michelle Kukla Psyd Pc |
|---|---|
| Speciality | Psychologist |
| Location | 800 E Northwest Hwy Ste 500, Palatine, Illinois |
| Authorized Official Name and Position | Michelle Kukla (OWNER) |
| Authorized Official Contact | 7085606653 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michelle Kukla Psyd Pc 800 E Northwest Hwy Ste 500 Palatine IL 60074-6511 Ph: (708) 560-6653 | Michelle Kukla Psyd Pc 800 E Northwest Hwy Ste 500 Palatine IL 60074-6511 Ph: (708) 560-6653 |
| NPI Number | 1225388697 |
|---|---|
| Provider Enumeration Date | 09/13/2012 |
| Last Update Date | 09/13/2012 |
| Medicare PECOS PAC ID | 0941454987 |
|---|---|
| Medicare Enrollment ID | O20130129000241 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225388697 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071006865 (Illinois) | Primary |
| Provider Name | Michelle A Kukla |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457383648 PECOS PAC ID: 2264451863 Enrollment ID: I20051114000172 |
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