Provider Demographics
NPI:1578686960
Name:MARGOLIN, CATHLEEN MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CATHLEEN
Middle Name:MARIE
Last Name:MARGOLIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 DELL LN
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-5311
Mailing Address - Country:US
Mailing Address - Phone:847-508-7176
Mailing Address - Fax:
Practice Address - Street 1:545 LINCOLN AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:WINNETKA
Practice Address - State:IL
Practice Address - Zip Code:60093-2349
Practice Address - Country:US
Practice Address - Phone:847-508-7176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical