Catherine Clark, SLP
Individual provider Active NPI Speech-Language Pathologist · Blue Island, IL
NPI 1407375264 · NPPES record last updated Sep 13, 2017
Key facts
- NPI
- 1407375264
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 146011716 (IL)
- Practice address
- 12700 Sacramento Ave
Blue Island, IL 60406-1822 - Phone
- (708) 597-6300
- NPI assigned
- Sep 13, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146011716 | IL | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146011716 | IL | Yes |
Addresses
Primary practice location
12700 Sacramento Ave
Blue Island, IL 60406-1822
Mailing address
10820 S Lawndale Ave
Chicago, IL 60655-3233
Phone (773) 318-4139
Other providers in Blue Island, IL
- Belinda Childs
- Lee R Christensen
- Michelle Elizabeth Churchey-Mims
- Aubrey Lynn Ciesiun
- City of Blue Island
- Julisa Clark
- Colten Dean Coffin
- Arlease Coleman
- Melissa Coleman
- Randi Coley
All providers in Blue Island, IL · Speech-Language Pathologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.