Provider Demographics
NPI:1093353328
Name:PIRRONE, FLAVIA KIMBERLY (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:FLAVIA
Middle Name:KIMBERLY
Last Name:PIRRONE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 W WILLOW ST APT 3B
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-5066
Mailing Address - Country:US
Mailing Address - Phone:630-254-4047
Mailing Address - Fax:
Practice Address - Street 1:3800 N CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-3606
Practice Address - Country:US
Practice Address - Phone:773-478-4222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146015013235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist