Provider Demographics
NPI:1225385578
Name:DEUTSCH, SAMANTHA LYNN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:LYNN
Last Name:DEUTSCH
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2144 W SCHILLER ST
Mailing Address - Street 2:UNIT 2B
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-3038
Mailing Address - Country:US
Mailing Address - Phone:847-774-0582
Mailing Address - Fax:
Practice Address - Street 1:2144 W SCHILLER ST
Practice Address - Street 2:UNIT 2B
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-3038
Practice Address - Country:US
Practice Address - Phone:847-774-0582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146009879235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist