MEDICARE: KATHERINE KADERABEK RBT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	17-44459	IL

General Provider Information

NPI Number	:	1285124289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE KADERABEK RBT

Provider Business Mailing Address
First Line	:	1129 N BEVERLY LN
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-4914
Country	:	US
Telephone Number	:	847-902-6978
Fax Number	:

Provider Business Practice Location Address
First Line	:	1129 N BEVERLY LN
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-4914
Country	:	US
Telephone Number	:	847-902-6978
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2018
Last Update Date	:	05/15/2018

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