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Organization
KIDNECTIVITY,LLC
Active
Organization
KIDNECTIVITY,LLC
Active
Parent organization
KIDNECTIVITY,LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
KIDNECTIVITY,LLC
Authorized official
JENIFER BATES (BUSINESS DIRECTOR)
(847) 748-8733
Entity
Organization
Contact information
Practice address
600 WAUKEGAN RD STE 132, NORTHBROOK, IL 60062-1249
(847) 748-8733
(847) 739-7164
Mailing address
600 WAUKEGAN RD STE 132, NORTHBROOK, IL 60062-1249
(847) 748-8733
(847) 739-7164
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001710375969
—
IL
Enumeration date
07/13/2022
Last updated
07/13/2022
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