Provider Demographics
NPI:1245981497
Name:KALOKHE, VERONICA GARZA
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:GARZA
Last Name:KALOKHE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 N MCCLURG CT APT 1201
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4150
Mailing Address - Country:US
Mailing Address - Phone:773-920-0225
Mailing Address - Fax:
Practice Address - Street 1:444 SKOKIE BLVD STE 212
Practice Address - Street 2:
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-3074
Practice Address - Country:US
Practice Address - Phone:847-834-9844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490194921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical