| Organization Name: | KIMBERLY MCRAE, INC. |
| NPI Number: | 1760657969 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KIMBERLY KAYE MCRAE (PRESIDENT/SPEECH-LANGUAGE PATHOLOGI) |
| Mailing Address: | 1868 W Broadsmore Ln Round Lake |
| State: | IL US |
| Postal Code: | 600738151 |
| Phone Number: | 2245225315 |
| Fax Number: | 8477409019 |
| NPI Enumeration Date: | 04/28/2008 |
| NPI Last Update Date: | 04/28/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0700X |
| License Number: | 146007781 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Hearing and Speech |
| Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, treatment, prescriptive, and therapy services related to congenital and acquired conditions and diseases that affect hearing capacity and speech ability. |