Healthcare Provider Details

I. General information

NPI: 1689165243
Provider Name (Legal Business Name): KATIE A KOWALESKI AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATIE A OESTREICH

II. Dates (important events)

Enumeration Date: 05/18/2018
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 WASHINGTON ST
GRAFTON WI
53024-1700
US

IV. Provider business mailing address

PO BOX 735044
CHICAGO IL
60673-5044
US

V. Phone/Fax

Practice location:
  • Phone: 262-375-3700
  • Fax: 262-376-6032
Mailing address:
  • Phone: 800-326-2250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number679-156
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: