Provider Demographics
NPI:1568804466
Name:ODONNELL, STEFANIE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:
Last Name:ODONNELL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 DELAWARE CT
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-5704
Mailing Address - Country:US
Mailing Address - Phone:847-414-7360
Mailing Address - Fax:847-430-4828
Practice Address - Street 1:18 DELAWARE CT
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60193-5704
Practice Address - Country:US
Practice Address - Phone:847-414-7360
Practice Address - Fax:847-430-4828
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-22
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146012399235Z00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist