Individual
HEBA I QANDEEL-KISHTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CADC I
Contact information
Practice address
7625 BROOKSIDE GLEN DR, TINLEY PARK, IL 60487-5197
(312) 371-9222
Mailing address
7625 BROOKSIDE GLEN DR, TINLEY PARK, IL 60487-5197
(312) 371-9222
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
33823
IL
101YM0800X
Mental Health Counselor
—
—
102L00000X
Psychoanalyst
—
—
103K00000X
Behavior Analyst
—
—
106E00000X
Assistant Behavior Analyst
—
—
146N00000X
Basic Emergency Medical Technician
—
—
171400000X
Health & Wellness Coach
—
—
171M00000X
Case Manager/Care Coordinator
—
—
171R00000X
Interpreter
—
—
171W00000X
Contractor
—
—
1744G0900X
Graphics Designer
—
—
1744R1102X
Research Study Specialist
—
—
251S00000X
Community/Behavioral Health Agency
—
—
372600000X
Adult Companion
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156547002
—
IL
Enumeration date
12/20/2023
Last updated
12/20/2023
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