Provider Demographics
NPI:1457472458
Name:GRAHAM, KRISTI J (PHD)
Entity Type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:J
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2100 MANCHESTER RD
Mailing Address - Street 2:SUITE 1510
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-4579
Mailing Address - Country:US
Mailing Address - Phone:630-653-1717
Mailing Address - Fax:630-653-1025
Practice Address - Street 1:180 N MICHIGAN AVE
Practice Address - Street 2:SUITE 2408
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7401
Practice Address - Country:US
Practice Address - Phone:630-653-1717
Practice Address - Fax:630-653-1025
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL71.007185103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist