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Individual

DR. KIMBERLY J CHIVERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
5412 N CLARK ST STE 204, CHICAGO, IL 60640-1272
(708) 655-3835
Mailing address
5315 N CLARK ST # 319, CHICAGO, IL 60640-2290
(708) 655-3835

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
180008812
IL
103TC0700X
Clinical Psychologist
Primary
071007991
IL

Other

Enumeration date
11/05/2013
Last updated
11/05/2013
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