Provider Demographics
NPI:1164946471
Name:BROTON, CHRISTIANNA (SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTIANNA
Middle Name:
Last Name:BROTON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:CHRISTIANNA
Other - Middle Name:
Other - Last Name:PATTERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1870 W WINCHESTER RD STE 203
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-5360
Mailing Address - Country:US
Mailing Address - Phone:847-816-7200
Mailing Address - Fax:
Practice Address - Street 1:1870 W WINCHESTER RD #203
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048
Practice Address - Country:US
Practice Address - Phone:847-816-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-28
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146012730235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist