Provider Demographics
NPI:1568653467
Name:SIMONYAN, EVELINA (MHS, CCC-SLP/L)
Entity Type:Individual
Prefix:MRS
First Name:EVELINA
Middle Name:
Last Name:SIMONYAN
Suffix:
Gender:F
Credentials:MHS, CCC-SLP/L
Other - Prefix:
Other - First Name:EVELIN
Other - Middle Name:
Other - Last Name:PIROGOVSKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2413 SEMINOLE CT
Mailing Address - Street 2:
Mailing Address - City:RIVERWOODS
Mailing Address - State:IL
Mailing Address - Zip Code:60015-3853
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2413 SEMINOLE CT
Practice Address - Street 2:
Practice Address - City:RIVERWOODS
Practice Address - State:IL
Practice Address - Zip Code:60015-3853
Practice Address - Country:US
Practice Address - Phone:847-638-1516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist