Provider Demographics
NPI:1164155982
Name:KAINOVIC, SCOTT C (LPC)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:C
Last Name:KAINOVIC
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1142 WHITE ST
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-6648
Mailing Address - Country:US
Mailing Address - Phone:773-450-6626
Mailing Address - Fax:
Practice Address - Street 1:2400 N ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-0851
Practice Address - Country:US
Practice Address - Phone:618-507-5262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-08
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor