Provider Demographics
NPI:1700575065
Name:RATTIGAN, KRISTIN MARIE
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:MARIE
Last Name:RATTIGAN
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 1:212 S MARION ST
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-3257
Mailing Address - Country:US
Mailing Address - Phone:312-415-5507
Mailing Address - Fax:
Practice Address - Street 1:212 S MARION ST STE 23
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-3159
Practice Address - Country:US
Practice Address - Phone:312-415-5507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker