Provider Demographics
NPI:1073894796
Name:BILAS, KRISTIN MELISSA (SLP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:MELISSA
Last Name:BILAS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9936 S TURNER AVE
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60805-3445
Mailing Address - Country:US
Mailing Address - Phone:708-945-5894
Mailing Address - Fax:
Practice Address - Street 1:9936 S TURNER AVE
Practice Address - Street 2:
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-3445
Practice Address - Country:US
Practice Address - Phone:708-945-5894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.001919235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist