Provider Demographics
NPI:1083122766
Name:OSTER, KELSEY ERIN (PSYD)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:ERIN
Last Name:OSTER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:ERIN
Other - Last Name:SIMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:1933 N MEACHAM RD STE 750
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4368
Mailing Address - Country:US
Mailing Address - Phone:708-665-5170
Mailing Address - Fax:847-906-1086
Practice Address - Street 1:1933 N MEACHAM RD STE 750
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4368
Practice Address - Country:US
Practice Address - Phone:708-665-5170
Practice Address - Fax:847-906-1086
Is Sole Proprietor?:No
Enumeration Date:2018-01-17
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.009662103TC0700X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical