Provider Demographics
NPI:1558517920
Name:MITCHELL, KARA A (MS, CCC-SLP/L)
Entity Type:Individual
Prefix:MRS
First Name:KARA
Middle Name:A
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MS, CCC-SLP/L
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:A
Other - Last Name:MITCHELL MILLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4341 S. KING DRIVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60653-3308
Mailing Address - Country:US
Mailing Address - Phone:708-537-9596
Mailing Address - Fax:708-747-0294
Practice Address - Street 1:4341 S KING DRIVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60653-3308
Practice Address - Country:US
Practice Address - Phone:708-537-9596
Practice Address - Fax:708-747-0294
Is Sole Proprietor?:No
Enumeration Date:2008-08-17
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146004112235Z00000X
IL1538460235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist