Provider Demographics
NPI:1629615034
Name:BOWKER, KATHERINE JULIET (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:JULIET
Last Name:BOWKER
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 1:676 N SAINT CLAIR ST STE 2030
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2830
Mailing Address - Country:US
Mailing Address - Phone:312-926-3627
Mailing Address - Fax:312-926-2200
Practice Address - Street 1:676 N SAINT CLAIR ST STE 2030
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2830
Practice Address - Country:US
Practice Address - Phone:312-926-3627
Practice Address - Fax:312-926-2200
Is Sole Proprietor?:No
Enumeration Date:2019-12-04
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1501027621041C0700X
IL1490217341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical