Individual
KATE KIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
332 S MICHIGAN AVE STE 900, CHICAGO, IL 60604-4393
(813) 395-1073
Mailing address
62 ALDER WAY, ROUND LAKE, IL 60073-1630
(773) 288-9634
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-284383
IL
Other
Enumeration date
08/29/2023
Last updated
05/12/2025
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