Provider Demographics
NPI:1093834228
Name:STANTON, SHEILA MARY (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:MARY
Last Name:STANTON
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 1:4921 N WOLCOTT AVE
Mailing Address - Street 2:2A
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-3326
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4921 N WOLCOTT AVE
Practice Address - Street 2:2A
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-3326
Practice Address - Country:US
Practice Address - Phone:773-561-4638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist