Provider Demographics
NPI:1417083304
Name:SCOTT, CHERYL M (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:M
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1534 W ESTES AVE # 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-2618
Mailing Address - Country:US
Mailing Address - Phone:312-942-3348
Mailing Address - Fax:312-942-7211
Practice Address - Street 1:1653 W CONGRESS PKWY
Practice Address - Street 2:SUITE 203 SENN
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3833
Practice Address - Country:US
Practice Address - Phone:312-942-3234
Practice Address - Fax:312-942-7211
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
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