Provider Demographics
NPI:1780149617
Name:RONAN, KATHERINE DUNNE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:DUNNE
Last Name:RONAN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:M
Other - Last Name:DUNNE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:2219 W EASTWOOD AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-2016
Mailing Address - Country:US
Mailing Address - Phone:773-968-8657
Mailing Address - Fax:
Practice Address - Street 1:2219 W EASTWOOD AVE FL 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-2016
Practice Address - Country:US
Practice Address - Phone:773-968-8657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-05
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146-004587235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist