Organization
CENTER FOR CHANGE & HEALING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN KELL LCSW (DIRECTOR OF INFORMATION)
(630) 849-6212
Entity
Organization
Contact information
Practice address
11S230 S JACKSON ST STE 104, BURR RIDGE, IL 60527-7099
(630) 712-6042
Mailing address
11S230 S JACKSON ST STE 104, BURR RIDGE, IL 60527-7099
(630) 712-6042
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003335076
NPI
IL
01
—
1023595238
NPI
IL
01
—
1174883862
NPI
IL
01
—
1598036386
NPI
IL
Enumeration date
10/29/2021
Last updated
10/29/2021
Update your record
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