Provider Demographics
NPI:1861863656
Name:MEYER, KAY B (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KAY
Middle Name:B
Last Name:MEYER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:KAY
Other - Middle Name:ANNETTE
Other - Last Name:BUSSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:92 FOXBORO LN
Mailing Address - Street 2:SUITE 204
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-4436
Mailing Address - Country:US
Mailing Address - Phone:847-204-8964
Mailing Address - Fax:
Practice Address - Street 1:92 FOXBORO LN
Practice Address - Street 2:SUITE 204
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-4436
Practice Address - Country:US
Practice Address - Phone:847-204-8964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.001705235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist