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General NPI Number Information
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NPI Number | 1639595945
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Entity Type | Individual
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Provider Name | KATHERINE DIXON
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Gender | Female
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Dates
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Enumeration Date | 03/11/2014
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Last Update Date | 05/06/2014
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Provider Practice Location Address
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Address Line | 2506 N CLARK ST
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City | CHICAGO
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State | IL
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Zip | 60614-1848
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Country | US
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Telephone | 312-278-0022
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Fax |
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Provider Business Mailing Address
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Address Line | 733 W WAVELAND AVE APT 3
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City | CHICAGO
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State | IL
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Zip | 60613-4171
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Country | US
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Telephone | 414-403-3608
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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