KEVIN CONNOLLY - NPI 1124419643 - Counselor in Bloomingdale, IL

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YP2500X and a focus in Professional.

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About Kevin Connolly NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEVIN CONNOLLY (NPI 1124419643) is an individual professional provider in Bloomingdale, Illinois, licensed in Illinois (180009277) and active in the NPI registry since February 2015.

NPPES Registry Identity

NPI1124419643

Entity TypeIndividualMale

Primary Taxonomy101YP2500X

Provider Legal NameKEVIN CONNOLLY

Location Address1 TIFFANY PT STE 110Bloomingdale, IL 60108-2915

Mailing Address1617 Lake AveWilmette, IL 60091-1535 · (773) 981-2972

Phone(773) 981-2972

Sole ProprietorYes

Enumeration DateFebruary 6, 2015

Last NPPES UpdateFebruary 12, 2015

✔ NPI 1124419643 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in IL · 180009277

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 180009277 (IL)

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 180009277 (IL)

Also ListedMarriage & Family TherapistTaxonomy 106H00000X · License 180009277 (IL)

1 TIFFANY PT STE 110, Bloomingdale, IL 60108

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Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SYED ALI IMRAN BOKHARI M.D.

Psychiatry & Neurology (Psychiatry)