Organization
INDEPENDENT PROVIDER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN MOLONEY M.S. CF-SLP (SPEECH-LANGUAGE PATHOLOGIST)
(773) 759-2403
Entity
Organization
Contact information
Practice address
3800 W 106TH ST, CHICAGO, IL 60655-3815
(773) 759-2403
Mailing address
3800 W 106TH ST, CHICAGO, IL 60655-3815
(773) 759-2403
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
242003723
IL
Other
Enumeration date
05/15/2016
Last updated
05/15/2016
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