Provider Demographics
NPI:1982803763
Name:LIABO, KATHRYN JENEE (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:JENEE
Last Name:LIABO
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 W WASHINGTON BLVD
Mailing Address - Street 2:UNIT 308
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-2137
Mailing Address - Country:US
Mailing Address - Phone:773-848-2207
Mailing Address - Fax:
Practice Address - Street 1:1000 W WASHINGTON BLVD
Practice Address - Street 2:UNIT 308
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-2137
Practice Address - Country:US
Practice Address - Phone:773-848-2207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist