Provider Demographics
NPI:1215401385
Name:HAMILTON, JULIE LYNN (MA CCC-SLP/L)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:LYNN
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MA 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 1:1500 STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-3867
Mailing Address - Country:US
Mailing Address - Phone:847-318-4360
Mailing Address - Fax:
Practice Address - Street 1:1500 STEWART AVE
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-3867
Practice Address - Country:US
Practice Address - Phone:847-318-4360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-11
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
146-003813235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist