Provider Demographics
NPI:1164778973
Name:GLINSEY, BEVERLY J (MS, SLP/L)
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:J
Last Name:GLINSEY
Suffix:
Gender:F
Credentials:MS, SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4342 S KING DR
Mailing Address - Street 2:UNIT 2
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60653-3309
Mailing Address - Country:US
Mailing Address - Phone:773-936-5363
Mailing Address - Fax:
Practice Address - Street 1:4342 S KING DR APT 2
Practice Address - Street 2:UNIT 2
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60653-3309
Practice Address - Country:US
Practice Address - Phone:773-936-5363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-30
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146009763235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist