Provider Demographics
NPI:1124163845
Name:KOVANIC, CATHLEEN (AUD, CCC-A)
Entity type:Individual
Prefix:
First Name:CATHLEEN
Middle Name:
Last Name:KOVANIC
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:CATHLEEN
Other - Middle Name:ANN
Other - Last Name:O'CONNOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AUD, CCC-A
Mailing Address - Street 1:2040 OGDEN AVE STE 401
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-7208
Mailing Address - Country:US
Mailing Address - Phone:630-978-6895
Mailing Address - Fax:630-375-2905
Practice Address - Street 1:2040 OGDEN AVE STE 401
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-7208
Practice Address - Country:US
Practice Address - Phone:630-978-6895
Practice Address - Fax:630-375-2905
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147-000008231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK02995Medicare ID - Type UnspecifiedDREYER MEDICARE NUMBER