Provider Demographics
NPI:1275029415
Name:DRISCOLL, CHRISTINE ALLISON (MS, CCC-SLP/L)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ALLISON
Last Name:DRISCOLL
Suffix:
Gender:F
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 1:2243 W THOMAS ST # 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-3515
Mailing Address - Country:US
Mailing Address - Phone:630-417-2334
Mailing Address - Fax:
Practice Address - Street 1:1757 N KIMBALL AVE # 205A
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-4805
Practice Address - Country:US
Practice Address - Phone:630-417-2334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-10
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146013900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist