Provider Demographics
NPI:1114216538
Name:NAGORSKI, KAREN LEE (MS, SLP, CCC)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LEE
Last Name:NAGORSKI
Suffix:
Gender:F
Credentials:MS, SLP, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1728 SUNRISE POINT
Mailing Address - Street 2:
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61761
Mailing Address - Country:US
Mailing Address - Phone:309-454-1969
Mailing Address - Fax:
Practice Address - Street 1:1728 SUNRISE POINT
Practice Address - Street 2:
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61761
Practice Address - Country:US
Practice Address - Phone:309-454-1969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.009962235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL146.009962OtherSTATE OF ILLINOIS DFPR LICENSED SPEECH PATHOLOGIST