Provider Demographics
NPI:1295726164
Name:KID TALK INC
Entity type:Organization
Organization Name:KID TALK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:A
Authorized Official - Last Name:DIETEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-462-0514
Mailing Address - Street 1:346 ALANA DR
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-1784
Mailing Address - Country:US
Mailing Address - Phone:815-462-0514
Mailing Address - Fax:815-462-3993
Practice Address - Street 1:346 ALANA DR
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-1784
Practice Address - Country:US
Practice Address - Phone:815-462-0514
Practice Address - Fax:815-462-3993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty