Provider Demographics
NPI:1578614517
Name:ZERNICKE, MICHELE LYNN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:LYNN
Last Name:ZERNICKE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:LYNN
Other - Last Name:SPAETTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2556 WHITEHALL LN
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-8438
Mailing Address - Country:US
Mailing Address - Phone:630-544-6888
Mailing Address - Fax:
Practice Address - Street 1:857 CENTER CT UNIT D
Practice Address - Street 2:
Practice Address - City:SHOREWOOD
Practice Address - State:IL
Practice Address - Zip Code:60431-8520
Practice Address - Country:US
Practice Address - Phone:815-730-1818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
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