Provider Demographics
NPI:1962136945
Name:PARDUN, KATHERINE LEE (LSW)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:LEE
Last Name:PARDUN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 PROSPECT CT
Mailing Address - Street 2:
Mailing Address - City:PROSPECT HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60070-1433
Mailing Address - Country:US
Mailing Address - Phone:224-636-3441
Mailing Address - Fax:
Practice Address - Street 1:275 W DUNDEE RD
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-3704
Practice Address - Country:US
Practice Address - Phone:847-777-8995
Practice Address - Fax:847-947-2890
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.108210104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker