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Individual

DR. KATHERINE BORCHARDT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
5007 LINCOLN AVE, SUITE 205, LISLE, IL 60532-4187
(630) 680-5494
(630) 369-5989
Mailing address
1212 S NAPER BLVD, STE. 119, NAPERVILLE, IL 60540-8360
(630) 680-5494
(630) 369-5989

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
071-005561
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2222171
BLUE CROSS PROVIDER NO
IL
Enumeration date
03/22/2007
Last updated
07/22/2013
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