Provider Demographics
NPI:1700423605
Name:STACHOWICZ, KAREN ANN (MA, CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ANN
Last Name:STACHOWICZ
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10500 LEXINGTON LN
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-2216
Mailing Address - Country:US
Mailing Address - Phone:815-245-5871
Mailing Address - Fax:
Practice Address - Street 1:420 N RAYNOR AVE
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6065
Practice Address - Country:US
Practice Address - Phone:815-740-3196
Practice Address - Fax:815-740-5955
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-10
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147.000242231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9907358OtherBCBS OF IL