Provider Demographics
NPI:1871808642
Name:CAMPBELL-SOLAK, KRISTINE (LCSW)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:
Last Name:CAMPBELL-SOLAK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KRISTINE
Other - Middle Name:
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:51 W SCHAUMBURG RD
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60194-3506
Mailing Address - Country:US
Mailing Address - Phone:815-469-1500
Mailing Address - Fax:779-216-3069
Practice Address - Street 1:51 W SCHAUMBURG RD
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60194-3506
Practice Address - Country:US
Practice Address - Phone:815-469-1500
Practice Address - Fax:779-216-3069
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16211041C0700X
IL1490119461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical