Provider Demographics
NPI:1538419684
Name:BOYCE, KATHLEEN (AUD)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:
Last Name:BOYCE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1034 WARREN AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-3601
Mailing Address - Country:US
Mailing Address - Phone:630-852-7325
Mailing Address - Fax:708-536-9968
Practice Address - Street 1:1034 WARREN AVE
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-3601
Practice Address - Country:US
Practice Address - Phone:630-852-7325
Practice Address - Fax:708-536-9968
Is Sole Proprietor?:No
Enumeration Date:2012-09-17
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147001436231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1684005Medicare PIN