Provider Demographics
NPI:1477851517
Name:CHICAGO SPEECH THERAPY, LLC
Entity Type:Organization
Organization Name:CHICAGO SPEECH THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:312-399-0370
Mailing Address - Street 1:230 W DIVISION ST
Mailing Address - Street 2:#908
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-4319
Mailing Address - Country:US
Mailing Address - Phone:312-399-0370
Mailing Address - Fax:312-278-0072
Practice Address - Street 1:230 W DIVISION ST
Practice Address - Street 2:#908
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-4319
Practice Address - Country:US
Practice Address - Phone:312-399-0370
Practice Address - Fax:312-278-0072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-13
Last Update Date:2011-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.0008526251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health