Provider Demographics
NPI:1144309535
Name:UMFRESS, KRIS SUSAN (PHD)
Entity type:Individual
Prefix:DR
First Name:KRIS
Middle Name:SUSAN
Last Name:UMFRESS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:836 CROSSLAND DR
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-7810
Mailing Address - Country:US
Mailing Address - Phone:847-723-6183
Mailing Address - Fax:847-723-6170
Practice Address - Street 1:1675 DEMPSTER ST
Practice Address - Street 2:SUITE Y2-108
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1110
Practice Address - Country:US
Practice Address - Phone:847-723-6183
Practice Address - Fax:847-723-6170
Is Sole Proprietor?:No
Enumeration Date:2006-11-04
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071006660103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical