MR. KIRK REMON RIDDLE


Address: 1525 E. 53rd Street, Suite 425, Chicago, IL 60615
Phone: 7738195504

MR. KIRK REMON RIDDLE (NPI# 1205387990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1205387990
Entity Type Individual
Full Name MR. KIRK REMON RIDDLE
Credential LICENSED PROFESSIONA
Practice Address 1525 E. 53rd Street, Suite 425
Chicago
IL 60615
Mailing Address 8627 S. Wood Street
Chicago
IL 60620
Practice Telephone 7738195504
Mailing Telephone 9045023007
Enumeration Date 2016-10-18
Last Update Date 2016-10-18
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YP2500X Counselor
Specialization: Professional
01YP2500X IL Behavioral Health & Social Service Providers

Office Location

Street Address 1525 E. 53RD STREET, SUITE 425
City CHICAGO
State IL
Zip Code 60615

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Taxonomy Information

Taxonomy Code 101YP2500X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Professional

Taxonomy Definition

Definition to come...

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Competitor

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City CHICAGO
Zip Code 60615

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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