Provider Demographics
NPI:1205844255
Name:MICHALOPULOS, ANASTASIOS (MS, CCC-SLP/L)
Entity Type:Individual
Prefix:
First Name:ANASTASIOS
Middle Name:
Last Name:MICHALOPULOS
Suffix:
Gender:M
Credentials:MS, CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 S MAIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-5485
Mailing Address - Country:US
Mailing Address - Phone:630-518-2525
Mailing Address - Fax:855-518-2525
Practice Address - Street 1:50 S MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-5485
Practice Address - Country:US
Practice Address - Phone:630-518-2525
Practice Address - Fax:855-518-2525
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146007025235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist