Provider Demographics
NPI:1619218492
Name:FLEISCHMANN, CANDICE (MS, CCC-SLP/L)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:
Last Name:FLEISCHMANN
Suffix:
Gender:F
Credentials:MS, CCC-SLP/L
Other - Prefix:
Other - First Name:CANDICE
Other - Middle Name:
Other - Last Name:BILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8142 N FARNSWORTH DR
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-2703
Mailing Address - Country:US
Mailing Address - Phone:847-533-0683
Mailing Address - Fax:
Practice Address - Street 1:8142 N FARNSWORTH DR
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-2703
Practice Address - Country:US
Practice Address - Phone:847-533-0683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146009160235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist