Provider Demographics
NPI:1609068311
Name:ZARAS, CARRY ELLEN (MSCCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CARRY
Middle Name:ELLEN
Last Name:ZARAS
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 DEERPATH LN
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60526-1020
Mailing Address - Country:US
Mailing Address - Phone:708-352-1398
Mailing Address - Fax:
Practice Address - Street 1:1506 DEERPATH LN
Practice Address - Street 2:
Practice Address - City:LA GRANGE PARK
Practice Address - State:IL
Practice Address - Zip Code:60526-1020
Practice Address - Country:US
Practice Address - Phone:708-352-1398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist