Kathryn Teresita Groleau, M.S.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

242003577 Issued in IL

Practice address

600 Stetzer St
Elburn, IL 60119-8316

Phone

(630) 430-2400

NPI assigned

Jun 10, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Kathryn Teresita Lally Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• KG Speech LLC

  • Speech-Language Pathologist
  • Maple Park, IL
  • NPI 1942131420
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1465516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465516800000",
    "number": "1003265950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 STETZER ST",
            "city": "ELBURN",
            "state": "IL",
            "postal_code": "601198316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 STETZER ST",
            "city": "ELBURN",
            "state": "IL",
            "postal_code": "601198316",
            "telephone_number": "630-430-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROLEAU",
        "first_name": "KATHRYN",
        "middle_name": "TERESITA",
        "name_prefix": "Mrs.",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-10",
        "last_updated": "2016-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242003577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "LALLY",
            "middle_name": "TERESITA",
            "prefix": "MS.",
            "credential": "M.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David Lin Foss, D.C.
• Kristy Ellen Gibson, M.A., CCC-SLP
• Loren M Gineris, PT
• Gliddons Drug Store Inc
• Myra Jo Griffey, RN
• Carolyn Haney
• Kathleen Hannemann
• Meghan Hill, CCC-SLP
• Keith E. Hougas, O.D.
• J&D Restorative Products, Inc.

• All providers in Elburn, IL
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.