Provider Demographics
NPI:1003025149
Name:KEMP, CAROL A (MSW)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:A
Last Name:KEMP
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-2727
Mailing Address - Country:US
Mailing Address - Phone:847-804-5516
Mailing Address - Fax:
Practice Address - Street 1:545 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:IL
Practice Address - Zip Code:60093-2349
Practice Address - Country:US
Practice Address - Phone:847-804-5516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149002593174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist