Provider Demographics
NPI:1669632766
Name:KARR, KORRIN E (SLP)
Entity Type:Individual
Prefix:
First Name:KORRIN
Middle Name:E
Last Name:KARR
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8253 W CHESTNUT CT
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-1592
Mailing Address - Country:US
Mailing Address - Phone:815-464-9195
Mailing Address - Fax:815-464-9196
Practice Address - Street 1:8253 W CHESTNUT CT
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-1592
Practice Address - Country:US
Practice Address - Phone:815-464-9195
Practice Address - Fax:815-464-9196
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146009179235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist