Provider Demographics
NPI:1043722317
Name:LAU, CATHERINE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:LAU
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 SAINT LOUIS AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-2930
Mailing Address - Country:US
Mailing Address - Phone:847-676-8017
Mailing Address - Fax:
Practice Address - Street 1:8300 SAINT LOUIS AVE
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-2930
Practice Address - Country:US
Practice Address - Phone:847-676-8017
Practice Address - Fax:847-676-8017
Is Sole Proprietor?:No
Enumeration Date:2017-10-26
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.007143235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist