Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0700X | Adult Development & Aging Psychologist | 071008692 | IL |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 071008692 | IL |
N | 103G00000X | Clinical Psychologist | 071008692 | IL |
N | 103TC0700X | Clinical Psychologist | 071008692 | IL |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 071008692 | IL |
N | 103TF0000X | Family Psychologist | 071008692 | IL |
Y | 103TP2701X | Group Psychotherapist | 071008692 | IL |
NPI | 1861823064 |
---|---|
Provider Name | Dr. David Kohler |
First Address | Chicago, IL 60618-7879 |
Second Address | Chicago, IL 60618-7879 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2013 |
Last Update Date | 13/12/2016 |