Provider Demographics
NPI:1366035610
Name:KAKICO
Entity Type:Organization
Organization Name:KAKICO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:WELSH
Authorized Official - Last Name:VOSS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW LSW
Authorized Official - Phone:847-334-5254
Mailing Address - Street 1:713 GLENWOOD LN
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-4019
Mailing Address - Country:US
Mailing Address - Phone:847-334-5254
Mailing Address - Fax:
Practice Address - Street 1:1247 WAUKEGAN RD
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-3057
Practice Address - Country:US
Practice Address - Phone:847-657-9890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty