Provider Demographics
NPI:1689140923
Name:JOU, VICKI (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:
Last Name:JOU
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2854 W ARMITAGE AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-4262
Mailing Address - Country:US
Mailing Address - Phone:501-256-6047
Mailing Address - Fax:
Practice Address - Street 1:2854 W ARMITAGE AVE APT 3
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-4262
Practice Address - Country:US
Practice Address - Phone:501-256-6047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-14
Last Update Date:2018-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist