Provider Demographics
NPI:1003969718
Name:YOUNG, KRISTEN M (AUD)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:M
Last Name:YOUNG
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2441 LAKE SHORE DR
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098-6911
Mailing Address - Country:US
Mailing Address - Phone:815-338-4600
Mailing Address - Fax:815-338-4611
Practice Address - Street 1:2441 LAKE SHORE DR
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-6911
Practice Address - Country:US
Practice Address - Phone:815-338-4600
Practice Address - Fax:815-338-4611
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist