MEDICARE: MRS. KARA A MITCHELL M.S., CCC-SLP/L

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	146004112	IL
2	235Z00000X	Speech-Language Pathologist	1538460	IL

General Provider Information

NPI Number	:	1558517920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KARA A MITCHELL M.S., CCC-SLP/L

Provider Business Mailing Address
First Line	:	4341 S. KING DRIVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60653-3308
Country	:	US
Telephone Number	:	708-537-9596
Fax Number	:	708-747-0294

Provider Business Practice Location Address
First Line	:	4341 S KING DRIVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60653-3308
Country	:	US
Telephone Number	:	708-537-9596
Fax Number	:	708-747-0294

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

Provider Enumeration Date	:	08/17/2008
Last Update Date	:	11/29/2023

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Directions to “ MRS. KARA A MITCHELL M.S., CCC-SLP/L” Practice Location

Language	Start Address	Practice Location

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