Provider Demographics
NPI:1760236343
Name:CKM PSYCHOLOGICAL SERVICES PLLC
Entity Type:Organization
Organization Name:CKM PSYCHOLOGICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CAMI
Authorized Official - Middle Name:K
Authorized Official - Last Name:MCBRIDE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:708-573-1937
Mailing Address - Street 1:101 N EUCLID AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-1431
Mailing Address - Country:US
Mailing Address - Phone:708-573-1937
Mailing Address - Fax:
Practice Address - Street 1:101 N EUCLID AVE APT 2
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1431
Practice Address - Country:US
Practice Address - Phone:708-573-1937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health