Healthcare Provider Details

I. General information

NPI: 1710821491
Provider Name (Legal Business Name): KATHRYN OCONNOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 MOON LAKE BLVD
HOFFMAN ESTATES IL
60169-1069
US

IV. Provider business mailing address

1721 MOON LAKE BLVD
HOFFMAN ESTATES IL
60169-1069
US

V. Phone/Fax

Practice location:
  • Phone: 708-927-4127
  • Fax: 708-927-4127
Mailing address:
  • Phone: 708-927-4127
  • Fax: 708-927-4127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: