Provider Demographics
NPI:1326012550
Name:HESTER, NANCY LYDIA (MED CCC-SPL)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:LYDIA
Last Name:HESTER
Suffix:
Gender:F
Credentials:MED CCC-SPL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3918 W BYRON ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-4039
Mailing Address - Country:US
Mailing Address - Phone:773-478-8645
Mailing Address - Fax:
Practice Address - Street 1:3918 W BYRON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-4039
Practice Address - Country:US
Practice Address - Phone:773-478-8645
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01635566OtherBLUE CROSS/BLUE S