Provider Demographics
NPI:1639949712
Name:KHRAIWISH, AREEG AWAD
Entity Type:Individual
Prefix:
First Name:AREEG
Middle Name:AWAD
Last Name:KHRAIWISH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18232 66TH AVE
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-4139
Mailing Address - Country:US
Mailing Address - Phone:708-971-3004
Mailing Address - Fax:
Practice Address - Street 1:18232 66TH AVE
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-4139
Practice Address - Country:US
Practice Address - Phone:708-971-3004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.007094235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist