Provider Demographics
NPI:1083792329
Name:SCHOOF, STEPHANIE LYN (MS CCC-SLP/L)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:LYN
Last Name:SCHOOF
Suffix:
Gender:F
Credentials:MS CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:70 POMEROY AVE
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-5946
Mailing Address - Country:US
Mailing Address - Phone:815-788-2740
Mailing Address - Fax:
Practice Address - Street 1:1095 PINGREE RD
Practice Address - Street 2:SUITE 119
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-1725
Practice Address - Country:US
Practice Address - Phone:847-458-8890
Practice Address - Fax:847-458-8889
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.007490235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist