Provider Demographics
NPI:1073944344
Name:CROHN, EMILY PATRICIA MONTEAGUDO (MS CCC-SLP/L)
Entity Type:Individual
Prefix:MRS
First Name:EMILY PATRICIA
Middle Name:MONTEAGUDO
Last Name:CROHN
Suffix:
Gender:F
Credentials:MS 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 1:1821 W PATTERSON AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-3521
Mailing Address - Country:US
Mailing Address - Phone:170-840-8001
Mailing Address - Fax:
Practice Address - Street 1:901 FOREST RD
Practice Address - Street 2:
Practice Address - City:LA GRANGE PARK
Practice Address - State:IL
Practice Address - Zip Code:60526
Practice Address - Country:US
Practice Address - Phone:708-408-0017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-11
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242002822235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist