Provider Demographics
NPI:1881928968
Name:NEENAN, KATHRYN (CCC SLP/L)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:NEENAN
Suffix:
Gender:F
Credentials:CCC SLP/L
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:NEENAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3739 N WILTON AVE
Mailing Address - Street 2:UNIT 3S
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-3915
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16W361 S FRONTAGE RD
Practice Address - Street 2:SUITE 131
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-5830
Practice Address - Country:US
Practice Address - Phone:630-590-5571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-23
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL14600995235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist