Provider Demographics
NPI:1134811763
Name:KOLKA, KAITLIN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:KOLKA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 N FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-2035
Mailing Address - Country:US
Mailing Address - Phone:847-804-3307
Mailing Address - Fax:
Practice Address - Street 1:10100 DEE RD
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-1512
Practice Address - Country:US
Practice Address - Phone:847-827-6231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist