Katherine Anne Formentini
Counselor, Professional in New Lenox, IL. Individual provider (NPI-1).
NPI number1861048993
StatusActive
Last updated in NPPESAug 14, 2019
Details
- NPI
- 1861048993
- Entity type
- Individual (NPI-1)
- Name
- Katherine Anne Formentini
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 14, 2019
- Last updated
- Aug 14, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 178.015057 | IL | Yes |
Practice location
1414 Eagle Vista DrNew Lenox, IL 60451-2315
Phone 815-931-2060
Mailing address
1414 Eagle Vista DrNew Lenox, IL 60451-2315
Phone 815-931-2060
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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