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NPI Code Detail

MEDICARE: KAITLIN AMANDA BERZSENYI M.A.

MEDICARE: KAITLIN AMANDA BERZSENYI M.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist24086CA
2235Z00000XSpeech-Language Pathologist146.012604IL

General Provider Information

NPI Number : 1700264876
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAITLIN AMANDA BERZSENYI M.A.
Provider Business Mailing Address
First Line : 4619 N RAVENSWOOD AVE STE 204
Second Line :
City : CHICAGO
State : IL
Zip : 60640-4579
Country : US
Telephone Number : 773-697-7333
Fax Number : 855-502-8892
Provider Business Practice Location Address
First Line : 4619 N RAVENSWOOD AVE STE 204
Second Line :
City : CHICAGO
State : IL
Zip : 60640-4579
Country : US
Telephone Number : 773-697-7333
Fax Number : 855-502-8892
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2015
Last Update Date : 10/01/2021

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Directions to “ KAITLIN AMANDA BERZSENYI M.A.” Practice Location

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