Provider Demographics
NPI:1982585733
Name:KEGG, NATALIE CORRINE
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:CORRINE
Last Name:KEGG
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 1:4N725 GRANDMAS LN
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175-4733
Mailing Address - Country:US
Mailing Address - Phone:312-248-3460
Mailing Address - Fax:
Practice Address - Street 1:3036 W IRVING PARK RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-3539
Practice Address - Country:US
Practice Address - Phone:773-270-1703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208.001366106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist