Provider Demographics
NPI:1588114490
Name:LAWTON, KATHRYN E (PHD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:E
Last Name:LAWTON
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 1:455 W GRANT PL
Mailing Address - Street 2:#13
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-3845
Mailing Address - Country:US
Mailing Address - Phone:630-886-3608
Mailing Address - Fax:
Practice Address - Street 1:1747 W ROOSEVELT RD STE 160
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-1264
Practice Address - Country:US
Practice Address - Phone:312-413-2985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-04
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071009371103TC0700X, 103TC2200X
103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical