Healthcare Provider Details

I. General information

NPI: 1598677734
Provider Name (Legal Business Name): KATHRYN NICOLE ALVSTAD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 N BOND ST
SPRINGFIELD IL
62702-4952
US

IV. Provider business mailing address

1669 HATTERAS DR
BOURBONNAIS IL
60914-9204
US

V. Phone/Fax

Practice location:
  • Phone: 217-545-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number147012379
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: