Provider Demographics
NPI:1184640435
Name:STEWART, CORINNE (MHS, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:CORINNE
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:MHS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 W COLLEGE DR
Mailing Address - Street 2:SUITE #800
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1785
Mailing Address - Country:US
Mailing Address - Phone:708-489-6777
Mailing Address - Fax:708-489-6303
Practice Address - Street 1:6400 W COLLEGE DR
Practice Address - Street 2:SUITE #800
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1785
Practice Address - Country:US
Practice Address - Phone:708-489-6777
Practice Address - Fax:708-489-6303
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
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