Provider Demographics
NPI:1164635280
Name:CONNERS, KRISTEN MARIE (MS, CCC-A)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:MARIE
Last Name:CONNERS
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12910 S LA GRANGE RD
Mailing Address - Street 2:
Mailing Address - City:PALOS PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60464-1717
Mailing Address - Country:US
Mailing Address - Phone:708-448-1234
Mailing Address - Fax:708-448-1402
Practice Address - Street 1:12910 S LA GRANGE RD
Practice Address - Street 2:
Practice Address - City:PALOS PARK
Practice Address - State:IL
Practice Address - Zip Code:60464-1717
Practice Address - Country:US
Practice Address - Phone:708-448-1234
Practice Address - Fax:708-448-1402
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147-000952231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist