Provider Demographics
NPI:1447587936
Name:KANG, PRISCILLA MURPHY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PRISCILLA
Middle Name:MURPHY
Last Name:KANG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 N DEARBORN ST FL 10
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-4322
Mailing Address - Country:US
Mailing Address - Phone:312-986-4158
Mailing Address - Fax:312-986-4187
Practice Address - Street 1:1 N DEARBORN ST FL 10
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-4322
Practice Address - Country:US
Practice Address - Phone:312-986-4158
Practice Address - Fax:312-986-4187
Is Sole Proprietor?:No
Enumeration Date:2009-11-04
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490136851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical