Provider Demographics
NPI:1366023350
Name:ARMAND, KATHLEEN (LMT)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:ARMAND
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4044 N LINCOLN AVE # 263
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-3038
Mailing Address - Country:US
Mailing Address - Phone:773-517-3905
Mailing Address - Fax:
Practice Address - Street 1:3900 N KEDZIE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-3416
Practice Address - Country:US
Practice Address - Phone:773-517-3905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227.011192225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist