Provider Demographics
NPI:1235424359
Name:BUEHNER, KELLI A (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:A
Last Name:BUEHNER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:KELLI
Other - Middle Name:A
Other - Last Name:KALAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:3170 N SHERIDAN RD
Mailing Address - Street 2:APT 708
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-4830
Mailing Address - Country:US
Mailing Address - Phone:773-358-0897
Mailing Address - Fax:
Practice Address - Street 1:3170 N SHERIDAN RD
Practice Address - Street 2:APT 219
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-4830
Practice Address - Country:US
Practice Address - Phone:773-358-0897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146011073235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist