Provider Demographics
NPI:1073977294
Name:JABLONSKI, RACHEL CUCULICH (MS CCC-SLP/L)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:CUCULICH
Last Name:JABLONSKI
Suffix:
Gender:F
Credentials:MS CCC-SLP/L
Other - Prefix:MISS
Other - First Name:RACHEL
Other - Middle Name:ROSE
Other - Last Name:CUCULICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP/L
Mailing Address - Street 1:8238 BROMLEY ST
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-2806
Mailing Address - Country:US
Mailing Address - Phone:708-642-2256
Mailing Address - Fax:
Practice Address - Street 1:8238 BROMLEY ST
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-2806
Practice Address - Country:US
Practice Address - Phone:708-642-2256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-13
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146012771235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist