Kc Eating Disorder Clinic Pllc

NPI #1326927971 in Champaign, Illinois

Provider Information

NPI Number: 1326927971
Entity Type: Organization
Organization Name: Kc Eating Disorder Clinic Pllc
Primary Specialty: Clinic/Center
Enumeration Date: Aug 28, 2025
Last Updated: Aug 28, 2025

Practice Location

Address: 313 N MATTIS AVE
City: Champaign
State: Illinois
ZIP Code: 61821-2460
Phone: (217) 377-0299

Authorized Official

Name: KAITLYN CORNELL, LCSW, CEDS-S
Title: CEO
Phone: (217) 621-0766

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X
Clinic/Center - Multi-Specialty — Multi-Specialty	261QM1300X
Nurse Practitioner - Psychiatric/Mental Health — Psychiatric/Mental Health	363LP0808X
Clinic/Center	261Q00000X	Primary

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