Individual
KATHLEEN GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
9500 BORMET DR, MOKENA, IL 60448-8303
(815) 469-1500
Mailing address
9500 BORMET DR STE 304, MOKENA, IL 60448-8399
(815) 469-1500
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
887686217C
PHCS PPO (PRIVATE INSURANCE)
—
Enumeration date
08/31/2011
Last updated
03/19/2026
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