Healthcare Provider Details

I. General information

NPI: 1487297263
Provider Name (Legal Business Name): KATHERINE THERESE HAGGERTY MS, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE THERESE TIGUE M.S. BCBA, LBA

II. Dates (important events)

Enumeration Date: 10/23/2019
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

778 W FRONTAGE RD STE 101
NORTHFIELD IL
60093-1209
US

IV. Provider business mailing address

4520 N SEELEY AVE APT 3E
CHICAGO IL
60625-1637
US

V. Phone/Fax

Practice location:
  • Phone: 312-780-0820
  • Fax:
Mailing address:
  • Phone: 219-707-1133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: