Provider Demographics
NPI:1013192699
Name:WALKER, KATHERINE A (MHRM, MS)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:A
Last Name:WALKER
Suffix:
Gender:F
Credentials:MHRM, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3N130 ATLANTIC DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-1756
Mailing Address - Country:US
Mailing Address - Phone:630-525-0025
Mailing Address - Fax:
Practice Address - Street 1:550 E WASHINGTON ST
Practice Address - Street 2:SUITE A
Practice Address - City:WEST CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60185-2228
Practice Address - Country:US
Practice Address - Phone:630-525-0025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2177402101YS0200X
IL101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health