Provider Demographics
NPI:1699088401
Name:DUNNETT, KRISTEN KAY (PSYD)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:KAY
Last Name:DUNNETT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 N KENSINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:IL
Mailing Address - Zip Code:60525-1868
Mailing Address - Country:US
Mailing Address - Phone:708-638-4467
Mailing Address - Fax:
Practice Address - Street 1:15 SPINNING WHEEL RD STE 118
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-2983
Practice Address - Country:US
Practice Address - Phone:888-726-7170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.006571101YM0800X
IL071.010222103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health