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Individual

DR. ANTOINETTE KAVANAUGH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
30 N MICHIGAN AVE, SUITE 1604, CHICAGO, IL 60602-3402
(312) 726-2914
Mailing address
30 N MICHIGAN AVE, SUITE 1604, CHICAGO, IL 60602-3402
(312) 726-2914

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
71005870
IL

Other

Enumeration date
02/13/2014
Last updated
02/13/2014
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