Provider Demographics
NPI:1477246395
Name:LESSARD, SAVANNAH FAYE (MS)
Entity Type:Individual
Prefix:MS
First Name:SAVANNAH
Middle Name:FAYE
Last Name:LESSARD
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5445 S WOODLAWN AVE APT 1W
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-5254
Mailing Address - Country:US
Mailing Address - Phone:321-615-5614
Mailing Address - Fax:
Practice Address - Street 1:3707 N KEDZIE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-4503
Practice Address - Country:US
Practice Address - Phone:773-377-5492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist