Provider Demographics
NPI:1053837328
Name:DEANGELIS, KRISTEN (MHS, CCC-SLP/L)
Entity Type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:
Last Name:DEANGELIS
Suffix:
Gender:F
Credentials:MHS, CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 KING ARTHUR WAY
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-2278
Mailing Address - Country:US
Mailing Address - Phone:630-739-3603
Mailing Address - Fax:
Practice Address - Street 1:500 KING ARTHUR WAY
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-2278
Practice Address - Country:US
Practice Address - Phone:630-739-3603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist