Healthcare Provider Details

I. General information

NPI: 1174433866
Provider Name (Legal Business Name): MARY KATHLEEN MCCARTHY CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MOLLY MCCARTHY

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 W 95TH ST
OAK LAWN IL
60453-2167
US

IV. Provider business mailing address

9835 S SAINT LOUIS AVE
EVERGREEN PARK IL
60805-3027
US

V. Phone/Fax

Practice location:
  • Phone: 708-599-5550
  • Fax:
Mailing address:
  • Phone: 708-712-1243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number146.018989
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: