Provider Demographics
NPI:1477693695
Name:SUHR, KELLY KRISTIN (MA CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:KRISTIN
Last Name:SUHR
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 N ORLEANS ST
Mailing Address - Street 2:#3W
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-6782
Mailing Address - Country:US
Mailing Address - Phone:312-643-2889
Mailing Address - Fax:
Practice Address - Street 1:2245 ENTERPRISE DR
Practice Address - Street 2:SUITE 4514
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-5813
Practice Address - Country:US
Practice Address - Phone:888-795-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
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