Provider Demographics
NPI:1740549955
Name:KINCAID, MARGARET MARY (PHD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:MARY
Last Name:KINCAID
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 1:811 CHICAGO AVE
Mailing Address - Street 2:#707
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-2391
Mailing Address - Country:US
Mailing Address - Phone:773-682-9301
Mailing Address - Fax:
Practice Address - Street 1:811 CHICAGO AVE
Practice Address - Street 2:#707
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-2391
Practice Address - Country:US
Practice Address - Phone:773-682-9301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-08
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.008129103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical