Healthcare Provider Details

I. General information

NPI: 1588943567
Provider Name (Legal Business Name): KATHRYN MARY PARDUE AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2011
Last Update Date: 07/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 S YORK ST STE 4180
ELMHURST IL
60126
US

IV. Provider business mailing address

172 E SCHILLER ST
ELMHURST IL
60126
US

V. Phone/Fax

Practice location:
  • Phone: 331-221-9004
  • Fax: 331-221-3998
Mailing address:
  • Phone: 331-221-6377
  • Fax: 331-221-2706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number147000499
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: