Provider Demographics
NPI:1003194374
Name:WAREHIME, ALEX LIZABETH (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:LIZABETH
Last Name:WAREHIME
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4451 N HAMILTON AVE
Mailing Address - Street 2:UNIT G
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-2198
Mailing Address - Country:US
Mailing Address - Phone:701-230-2501
Mailing Address - Fax:
Practice Address - Street 1:8833 GROSS POINT RD
Practice Address - Street 2:307
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1859
Practice Address - Country:US
Practice Address - Phone:701-230-2501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3138235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist