Provider Demographics
NPI:1659989713
Name:LUNN, TAYLOR MICHELLE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:MICHELLE
Last Name:LUNN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 W GRACE ST APT 1S
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-4115
Mailing Address - Country:US
Mailing Address - Phone:815-481-2485
Mailing Address - Fax:
Practice Address - Street 1:720 W GRACE ST APT 1S
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-4115
Practice Address - Country:US
Practice Address - Phone:815-481-2485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-15
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146015163235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist