Provider Demographics
NPI:1164895983
Name:DAY, CAROLYN (BS, MED,)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:DAY
Suffix:
Gender:F
Credentials:BS, MED,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 S CHICAGO BEACH DR
Mailing Address - Street 2:2002S
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-7032
Mailing Address - Country:US
Mailing Address - Phone:312-391-6929
Mailing Address - Fax:
Practice Address - Street 1:4800 S CHICAGO BEACH DR
Practice Address - Street 2:2002S
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-7032
Practice Address - Country:US
Practice Address - Phone:312-391-6929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-02
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2170000582355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant