Basic Information
| Provider Information | |||||||||
| NPI: | 1003822107 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROW | ||||||||
| FirstName: | KATRINA | ||||||||
| MiddleName: | I | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | AU.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | BANOWETZ | ||||||||
| OtherFirstName: | KATRINA | ||||||||
| OtherMiddleName: | I | ||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 215 SHUMAN BLVD | ||||||||
| Address2: | SUITE 401 | ||||||||
| City: | NAPERVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605638458 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3312298316 | ||||||||
| FaxNumber: | 9783136824 | ||||||||
| Practice Location | |||||||||
| Address1: | 111 N WABASH AVE | ||||||||
| Address2: | SUITE 1618 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606021903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3122510100 | ||||||||
| FaxNumber: | 3122510123 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2006 | ||||||||
| LastUpdateDate: | 11/19/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 3412 | SC | N | Speech, Language and Hearing Service Providers | Audiologist | 231HA2500X | 147.001323 | IL | Y | Speech, Language and Hearing Service Providers | Audiologist | Assistive Technology Supplier |
No ID Information.