Provider Demographics
NPI:1598930935
Name:SHER, CARRYL (MA CCC-SLP/L)
Entity Type:Individual
Prefix:
First Name:CARRYL
Middle Name:
Last Name:SHER
Suffix:
Gender:F
Credentials:MA CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 N WOLCOTT AVE APT 201
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-7229
Mailing Address - Country:US
Mailing Address - Phone:773-398-7873
Mailing Address - Fax:773-486-4177
Practice Address - Street 1:919 N WOLCOTT AVE APT 201
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-7229
Practice Address - Country:US
Practice Address - Phone:773-398-7873
Practice Address - Fax:773-486-4177
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146-005299235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist