Provider Demographics
NPI:1932989043
Name:MCKEVITT, CAITLYN EILZABETH (MS,CF-SLP)
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:EILZABETH
Last Name:MCKEVITT
Suffix:
Gender:F
Credentials:MS,CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19100 CRESCENT DR STE 101
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-7526
Mailing Address - Country:US
Mailing Address - Phone:708-478-5400
Mailing Address - Fax:708-478-5300
Practice Address - Street 1:19100 CRESCENT DR STE 101
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-7526
Practice Address - Country:US
Practice Address - Phone:708-724-5026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.007424235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist