Provider Demographics
NPI:1407004062
Name:DUNCKLEY, KATHLEEN THERESA (PHD)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:THERESA
Last Name:DUNCKLEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7619 N SHERIDAN RD
Mailing Address - Street 2:APT 1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-2049
Mailing Address - Country:US
Mailing Address - Phone:872-230-1158
Mailing Address - Fax:
Practice Address - Street 1:1653 W CONGRESS PKWY
Practice Address - Street 2:DEPT OF COMMUNICATION DISORDERS & SCIENCES
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3833
Practice Address - Country:US
Practice Address - Phone:312-942-4921
Practice Address - Fax:312-942-7068
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147.001266231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist