# DR. MEG MICHELLE KWAK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1851441299
- **Gender:** F
- **Credential:** PHD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TB0200X | Cognitive & Behavioral Psychologist | 060-005216 | IL | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | 060-005216 | IL | Yes |
| 103TS0200X | School Psychologist | 060-005216 | IL | — |

## Other

- **Enumeration date:** 01/10/2007
- **Last updated:** 08/08/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1673285 | BLUE CROSS/ BLUE SHIELD | IL |