Healthcare Provider Details

I. General information

NPI: 1194171140
Provider Name (Legal Business Name): KARLENE TARRAN M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2016
Last Update Date: 05/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 N JANE DR
ELGIN IL
60123-5118
US

IV. Provider business mailing address

425 W SURF ST APT 817
CHICAGO IL
60657-6450
US

V. Phone/Fax

Practice location:
  • Phone: 847-667-3750
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number146013119
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: