Organization
KRISTIN BURNS MIND AND BODY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIN BURNS LCSW (OWNER)
(312) 852-0515
Entity
Organization
Contact information
Practice address
715 LAKE ST STE 703, OAK PARK, IL 60301
(312) 852-0515
Mailing address
1115 THATCHER AVE, RIVER FOREST, IL 60305-1332
(312) 852-0515
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
248-002249
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316369630
BCBS OF IL PPO
IL
Enumeration date
09/18/2017
Last updated
08/09/2018
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