Provider Demographics
NPI:1013348150
Name:MARKOVICH, KRISTEN M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:M
Last Name:MARKOVICH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1633 W SCHAUMBURG RD
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60194-3902
Mailing Address - Country:US
Mailing Address - Phone:630-291-1097
Mailing Address - Fax:
Practice Address - Street 1:18-5 E DUNDEE RD
Practice Address - Street 2:SUITE 130
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-7412
Practice Address - Country:US
Practice Address - Phone:630-291-1097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-27
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.008628103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical