Doctor Name: | MRS. KELLY KATHLEEN DEVEREUX |
NPI Number: | 1437478112 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. CCC-SLP |
License Number: | 146005676 |
Business Practice Address: | 19100 Crescent Dr Suite 101 Mokena, IL - 604487510 |
Business Phone Number: | 7084785400 |
Business Fax Number: | |
Mailing Address: | 17820 Harper Rd, TINLEY PARK |
State: | IL |
Postal Code: | 604872139 |
Phone Number: | 7084447002 |
Fax Number: | |
NPI Enumeration Date: | 05/20/2010 |
NPI Last Update Date: | 05/20/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 146005676 |
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 |