Provider Demographics
NPI:1447474473
Name:BILLINGHAM, KATHERINE ANNE (PHD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:ANNE
Last Name:BILLINGHAM
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 DOWNING RD
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60546-1735
Mailing Address - Country:US
Mailing Address - Phone:312-822-0705
Mailing Address - Fax:
Practice Address - Street 1:625 N MICHIGAN AVE
Practice Address - Street 2:SUITE 1750
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3110
Practice Address - Country:US
Practice Address - Phone:312-822-0705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL7100002469103TB0200X, 103TH0004X
IL103T00000X, 103TC0700X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist