Provider Demographics
NPI:1003826124
Name:BIELSKIS, KRISTYN (SPEECH-LANGUAGE PATH)
Entity Type:Individual
Prefix:
First Name:KRISTYN
Middle Name:
Last Name:BIELSKIS
Suffix:
Gender:F
Credentials:SPEECH-LANGUAGE PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2008 SOUTHFIELD LN
Mailing Address - Street 2:
Mailing Address - City:BYRON
Mailing Address - State:IL
Mailing Address - Zip Code:61010-8975
Mailing Address - Country:US
Mailing Address - Phone:815-234-8186
Mailing Address - Fax:
Practice Address - Street 1:2008 SOUTHFIELD LN
Practice Address - Street 2:
Practice Address - City:BYRON
Practice Address - State:IL
Practice Address - Zip Code:61010-8975
Practice Address - Country:US
Practice Address - Phone:815-234-8186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist