Provider Demographics
NPI:1417488891
Name:MCEVOY, SHERYL (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:
Last Name:MCEVOY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11016 GRANITE DR
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-1072
Mailing Address - Country:US
Mailing Address - Phone:708-478-0545
Mailing Address - Fax:
Practice Address - Street 1:11016 GRANITE DR
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-1072
Practice Address - Country:US
Practice Address - Phone:708-478-0545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-27
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146010638235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist