ERIN KATHLEEN IMMKEN (NPI# 1679728356) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679728356 |
| Entity Type | Individual |
| Full Name | ERIN KATHLEEN IMMKEN |
| Other Name | ERIN KATHLEEN BOSTICK |
| Credential | LPC, LCPC |
| Practice Address |
98 Junction Drive West Suite 6 Glen Carbon IL 62034 |
| Mailing Address |
Po Box 98 Edwardsville IL 62025-0098 |
| Practice Telephone | 6187104123 |
| Practice Fax Number | 6187314082 |
| Mailing Telephone | 6187104123 |
| Mailing Fax Number | 6187314082 |
| Enumeration Date | 2008-11-24 |
| Last Update Date | 2015-05-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
180.006806 | IL | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
2008034953 | MO | Behavioral Health & Social Service Providers |
| Street Address |
98 JUNCTION DRIVE WEST SUITE 6 |
| City | GLEN CARBON |
| State | IL |
| Zip Code | 62034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740787795 | Kaleena Galletta | Nurse Practitioner | 4273 S., Il - 159, Glen Carbon, IL 62034 | 2018-04-06 |
| 1871092502 | Andrea Lee Sullivan | Dentist | 3024 South Il-159, Glen Carbon, IL 62034 | 2018-02-08 |
| 1417464918 | Stages Health & Wellness, LLC | Nurse Practitioner | 14 Crabapple Lane, Glen Carbon, IL 62034 | 2018-01-05 |
| 1700300498 | Michael Jay Arnold | Dentist | 3024 Il-159, Glen Carbon, IL 62034 | 2017-08-03 |
| 1679024228 | 360 Body Wellness Inc | Internal Medicine | 3407 Il State Route 157, Glen Carbon, IL 62034 | 2016-10-19 |
| 1346621505 | Stephanie N Lorts | Pediatrics | 4804 South State Route 159, Glen Carbon, IL 62034 | 2015-06-13 |
| 1205110111 | James Allan Staley | Pharmacist | #2 Cottonwood Rd, Glen Carbon, IL 62034 | 2011-10-11 |
| 1215224357 | Angela Eleni Kioultzopoulos | Speech-Language Pathologist | 7a Ginger Creek Village Dr., Glen Carbon, IL 62034 | 2011-07-08 |
| 1922320795 | Meridian Village Association | Skilled Nursing Facility | 27 Auerbach Place, Glen Carbon, IL 62034 | 2010-02-22 |
| 1689886681 | Dental Professionals of Illinois, P.C. | Dentist | 4235 S State Road 159, Glen Carbon, IL 62034 | 2007-05-04 |
| Find all providers in zip 62034 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447817713 | Brooke Ann Pellok Harris | Counselor | 2220 S State Route 157 Ste 200d, Glen Carbon, IL 62034-1724 | 2019-05-22 |
| 1982922274 | Kristin Marie Roberts | Counselor | 9 Junction Dr W Ste 3, Glen Carbon, IL 62034-2931 | 2010-05-11 |
| 1689902645 | Elisa Renee Jellen | Counselor | 30 Grainey Dr, Glen Carbon, IL 62034-3217 | 2009-12-02 |
| 1861642134 | Kristi Duelm | Counselor | 2 Gray Wolfe Ct, Glen Carbon, IL 62034-1374 | 2008-09-24 |
| 1215081195 | Vickie Marie Hendricks | Counselor | 4990 Rte 159, Glen Carbon, IL 62034 | 2007-01-22 |
| 1356318638 | Paula H Post | Counselor | 16 Junction Dr W, Glen Carbon, IL 62034-2996 | 2006-03-04 |
| 1295724672 | Elizabeth Warner | Counselor | 7 Glen Ed Professional Park, Glen Carbon, IL 62034-3333 | 2005-10-18 |
| 1285246280 | Megan Elizabeth Prior | Counselor | 46 Morningside Dr, Glen Carbon, IL 62034-1472 | 2020-08-20 |
| 1306308713 | Sandrarae Venita Hyatt | Counselor | 198 S Main St, Glen Carbon, IL 62034-1419 | 2019-04-03 |
| 1932519238 | Katie Roemer | Counselor | 9 Junction Dr W Ste 3, Glen Carbon, IL 62034-2931 | 2014-05-07 |
| Find all providers in GLEN CARBON | ||||
| City | GLEN CARBON |
| Zip Code | 62034 |
Please comment or provide details below to improve the information on ERIN KATHLEEN IMMKEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.