Doctor Name: | KERRY PHELAN |
NPI Number: | 1215303326 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. CCC-SLP |
License Number: | 146011788 |
Business Practice Address: | 4560 W 103rd St Unit 2 Oak Lawn, IL - 604534869 |
Business Phone Number: | 7085815798 |
Business Fax Number: | 7085815799 |
Mailing Address: | 1600 S Indiana Ave, Unit 509 CHICAGO |
State: | IL |
Postal Code: | 606164732 |
Phone Number: | 7089772354 |
Fax Number: | |
NPI Enumeration Date: | 08/12/2015 |
NPI Last Update Date: | 08/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 146011788 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |