MEDICARE: KATHRYN PAULA HUCK

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	235Z00000X	Speech-Language Pathologist
2	235Z00000X	Speech-Language Pathologist	146009529	IL

General Provider Information

NPI Number	:	1487806873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN PAULA HUCK

Provider Business Mailing Address
First Line	:	1900 W DICKENS AVE APT 2F
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-3924
Country	:	US
Telephone Number	:	773-386-3112
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 W DICKENS AVE APT 2F
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-3924
Country	:	US
Telephone Number	:	773-386-3112
Fax Number	:

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

Provider Enumeration Date	:	10/16/2008
Last Update Date	:	03/20/2024

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Directions to “ KATHRYN PAULA HUCK ” Practice Location

Language	Start Address	Practice Location

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