Healthcare Provider Details

I. General information

NPI: 1417689621
Provider Name (Legal Business Name): KATHERINE CAULFIELD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2022
Last Update Date: 06/27/2022
Certification Date: 06/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2013 MIDWEST RD
OAK BROOK IL
60523-1312
US

IV. Provider business mailing address

5537 S MELVINA AVE
CHICAGO IL
60638-2621
US

V. Phone/Fax

Practice location:
  • Phone: 630-495-0220
  • 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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: