Provider Demographics
NPI:1720737547
Name:SWEET, KATIE
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:SWEET
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 1:1539 N WICKER PARK AVE # 2W
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-1980
Mailing Address - Country:US
Mailing Address - Phone:312-339-9102
Mailing Address - Fax:
Practice Address - Street 1:123 W MADISON ST STE 2150
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-4592
Practice Address - Country:US
Practice Address - Phone:312-500-7795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-20
Last Update Date:2022-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health