Kimberly M Antos-Hogan, MA,LCPC, CRC,
Counselor, Professional in Glen Ellyn, IL. Individual provider (NPI-1).
NPI number1780192724
StatusActive
Last updated in NPPESJan 11, 2018
Details
- NPI
- 1780192724
- Entity type
- Individual (NPI-1)
- Name
- Kimberly M Antos-Hogan
- Credential
- MA,LCPC, CRC,
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 11, 2018
- Last updated
- Jan 11, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 180000743 | IL | Yes |
Practice location
21w675 Dorchester CtGlen Ellyn, IL 60137-6411
Phone 630-740-8559 · Fax 630-740-8559
Mailing address
21w675 Dorchester CtGlen Ellyn, IL 60137-6411
Phone 630-858-7030
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