Provider Demographics
NPI:1649648312
Name:DEJMEK, KATHERINE MARIE (MA, CF-SLP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MARIE
Last Name:DEJMEK
Suffix:
Gender:F
Credentials:MA, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2629 E WALNUT CT
Mailing Address - Street 2:
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-1000
Mailing Address - Country:US
Mailing Address - Phone:630-292-4064
Mailing Address - Fax:
Practice Address - Street 1:3351 HOBSON RD
Practice Address - Street 2:SUITE B
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517-1665
Practice Address - Country:US
Practice Address - Phone:630-541-3652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-10
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242003672235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist