Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Kenneth Kikuchi, PSYD

Individual provider Clinical Psychologist · NPI 1831673862

Dr. Kenneth Kikuchi, PSYD is a Clinical Psychologist in Park Ridge, Illinois. Qualified in 2004, 22 years ago. Practices as a sole proprietor. Licensed in Illinois.

Years since qualifying
22
Licensed in
IL
In the registry since
2018
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

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Practice location Address checks out

111 S Washington Ave Ste 202
Park Ridge, IL 60068-4293
Phone: (872) 228-5326
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 071009712 (IL)

Record details

NPI number1831673862
Entity typeIndividual (Type 1)
GenderMale
Credentials PSYD
Sole proprietorYes
NPI enumeratedSeptember 14, 2018
Last updated in NPPESFebruary 5, 2023
Certification dateFebruary 5, 2023
Mailing address4828 Fargo Ave, Skokie, IL 60077-3345

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Accepts Medicare assignment Not indicated

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