Healthcare Provider Details

I. General information

NPI: 1598512832
Provider Name (Legal Business Name): KB BILINGUAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2024
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1089 ROCKPORT DR
CAROL STREAM IL
60188-2984
US

IV. Provider business mailing address

1089 ROCKPORT DR
CAROL STREAM IL
60188-2984
US

V. Phone/Fax

Practice location:
  • Phone: 630-292-8903
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: KATARZYNA M BIELAK
Title or Position: OWNER
Credential:
Phone: 630-292-8903