Individual
CHARLES KIMBALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
939 W NORTH AVE STE 750, CHICAGO, IL 60642-7142
(312) 600-0409
Mailing address
3923 W SCHUBERT AVE APT 1, CHICAGO, IL 60647-8139
(530) 304-2612
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
05/06/2024
Last updated
05/06/2024
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