Individual
KATHLEEN S. LISTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-A
Contact information
Practice address
775 WAUKEGAN RD, SUITE 200, DEERFIELD, IL 60015-4342
(847) 267-8200
(847) 267-9440
Mailing address
5600 HICHITEE CT, LIBERTY TWP, OH 45011-1282
(847) 267-8200
(847) 267-9440
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
A.00793
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000513135
ANTHEM BCBS
OH
01
—
000000543958
ANTHEM BCBS
OH
05
—
2710794
—
OH
Enumeration date
01/09/2007
Last updated
05/09/2008
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