Provider Demographics
NPI:1760674543
Name:DAHM, KATHERINE (PHD)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:
Last Name:DAHM
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 1:820 S DAMEN AVE
Mailing Address - Street 2:OGDEN BLDG, 6TH FL
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3728
Mailing Address - Country:US
Mailing Address - Phone:312-569-5777
Mailing Address - Fax:312-569-6144
Practice Address - Street 1:820 S DAMEN AVE
Practice Address - Street 2:OGDEN BLDG, 6TH FL
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3728
Practice Address - Country:US
Practice Address - Phone:312-569-5777
Practice Address - Fax:312-569-6144
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.008987103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical