Individual
DR. KIMBERLY ANN DIENES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
431 S DEARBORN ST, SUITE 702, CHICAGO, IL 60605-1100
(312) 504-4363
(312) 279-7576
Mailing address
431 S DEARBORN ST, SUITE 702, CHICAGO, IL 60605-1100
(312) 504-4363
(312) 279-7576
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071007918
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
071007918
CLINICAL PSYCHOLOGIST LICENSE NUMBER
IL
Enumeration date
10/27/2012
Last updated
10/27/2012
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