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General NPI Number Information
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NPI Number | 1851709349
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Entity Type | Individual
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Provider Name | KAY ELLYN MCKINNEY-GEHRKE
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Gender | Female
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Dates
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Enumeration Date | 07/28/2014
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Last Update Date | 11/30/2023
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Provider Practice Location Address
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Address Line | 1301 W COSSITT AVE
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City | LA GRANGE
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State | IL
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Zip | 60525-2145
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Country | US
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Telephone | 708-482-1181
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Fax |
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Provider Business Mailing Address
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Address Line | 747 S PROSPECT AVE
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City | ELMHURST
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State | IL
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Zip | 60126-4327
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Country | US
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Telephone | 312-961-1532
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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 | 146005912
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License Number State | IL
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