Provider Demographics
NPI:1447940606
Name:DIRILTEN, KAMIL (MS STUDENT COUNSELOR)
Entity type:Individual
Prefix:
First Name:KAMIL
Middle Name:
Last Name:DIRILTEN
Suffix:
Gender:M
Credentials:MS STUDENT COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4614 MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-1212
Mailing Address - Country:US
Mailing Address - Phone:630-201-2856
Mailing Address - Fax:
Practice Address - Street 1:4614 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-1212
Practice Address - Country:US
Practice Address - Phone:630-201-2856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program