Provider Demographics
NPI:1982038071
Name:HARRIS, KATHERINE (PHD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 MILLER DR
Mailing Address - Street 2:STE 105
Mailing Address - City:NORTH AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60542-5144
Mailing Address - Country:US
Mailing Address - Phone:630-570-0050
Mailing Address - Fax:630-570-0045
Practice Address - Street 1:66 MILLER DR
Practice Address - Street 2:STE 105
Practice Address - City:NORTH AURORA
Practice Address - State:IL
Practice Address - Zip Code:60542-5144
Practice Address - Country:US
Practice Address - Phone:630-570-0050
Practice Address - Fax:630-570-0045
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071008711103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical