Provider Demographics
NPI:1912232497
Name:HEINTZ, KATHERINE SUE (MS CCC SLP)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:SUE
Last Name:HEINTZ
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:SUE
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC SLP
Mailing Address - Street 1:1330 FORESTDALE CT
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-1281
Mailing Address - Country:US
Mailing Address - Phone:815-997-6016
Mailing Address - Fax:
Practice Address - Street 1:1330 FORESTDALE CT
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60193-1281
Practice Address - Country:US
Practice Address - Phone:815-997-6016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146009835235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist