Provider Demographics
NPI:1609339225
Name:STEIVE, JENY THOMAS (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JENY
Middle Name:THOMAS
Last Name:STEIVE
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MS
Other - First Name:JENY
Other - Middle Name:SARA
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:8533 N OVERHILL AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-2047
Mailing Address - Country:US
Mailing Address - Phone:847-909-1935
Mailing Address - Fax:
Practice Address - Street 1:1110 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-2996
Practice Address - Country:US
Practice Address - Phone:224-303-1846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-10
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist