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General NPI Number Information
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NPI Number | 1902046741
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Entity Type | Individual
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Provider Name | KATHLEEN A'HEARN NOVAK D.C.
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Gender | Female
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Dates
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Enumeration Date | 03/05/2009
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Last Update Date | 11/11/2010
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Provider Practice Location Address
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Address Line | 2531 DIVISION ST
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City | JOLIET
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State | IL
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Zip | 60435-8734
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Country | US
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Telephone | 815-744-4010
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Fax | 815-744-4888
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Provider Business Mailing Address
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Address Line | 17830 CRYSTAL LAKE DR
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City | HOMER GLEN
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State | IL
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Zip | 60491-6169
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Country | US
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Telephone | 815-260-3801
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Fax | 815-717-6292
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038005532
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License Number State | IL
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