Provider Demographics
NPI:1548085376
Name:KANIA, OLIVIA ANN
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:ANN
Last Name:KANIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4432 N MAJOR AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-3326
Mailing Address - Country:US
Mailing Address - Phone:773-640-1967
Mailing Address - Fax:
Practice Address - Street 1:915 NATIONAL PKWY
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-5160
Practice Address - Country:US
Practice Address - Phone:847-443-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst