Provider Demographics
NPI:1487981130
Name:DILLINGHAM, KATHERINE PRICE (MA, RDT)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:PRICE
Last Name:DILLINGHAM
Suffix:
Gender:F
Credentials:MA, RDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3039 N KARLOV AVE
Mailing Address - Street 2:FL 1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-5434
Mailing Address - Country:US
Mailing Address - Phone:347-393-7014
Mailing Address - Fax:
Practice Address - Street 1:3039 N KARLOV AVE
Practice Address - Street 2:FL 1
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-5434
Practice Address - Country:US
Practice Address - Phone:347-393-7014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-17
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health