Healthcare Provider Details

I. General information

NPI: 1427128966
Provider Name (Legal Business Name): KAREN M GONZALEZ M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN A MALONE

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 04/27/2022
Certification Date: 04/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26156 N ACORN LN
MUNDELEIN IL
60060-4071
US

IV. Provider business mailing address

1011 N ILLINOIS AVE
ARLINGTON HEIGHTS IL
60004-4407
US

V. Phone/Fax

Practice location:
  • Phone: 847-566-9221
  • Fax:
Mailing address:
  • Phone: 847-253-8385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number146-007487
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: