Provider Demographics
NPI:1649562059
Name:KAPLAN, LIANNE FAYE (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LIANNE
Middle Name:FAYE
Last Name:KAPLAN
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:MRS
Other - First Name:LIANNE
Other - Middle Name:FAYE
Other - Last Name:FAKTOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 N MCCLURG CT APT 1906
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4341
Mailing Address - Country:US
Mailing Address - Phone:646-675-4174
Mailing Address - Fax:
Practice Address - Street 1:606 W ROOSEVELT RD
Practice Address - Street 2:SUITE 2E
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-4912
Practice Address - Country:US
Practice Address - Phone:312-588-5050
Practice Address - Fax:312-588-5040
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.012253235Z00000X
TX105018235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist