Provider Demographics
NPI:1689780389
Name:COURTNEY CHAPMAN LTD
Entity Type:Organization
Organization Name:COURTNEY CHAPMAN LTD
Other - Org Name:COURTNEY CHAPMAN LEDERER MA CCC-SLP
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT SPEECH-LANGUAGE PATH
Authorized Official - Prefix:MS
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:CHAPMAN
Authorized Official - Last Name:LEDERER
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC SLP
Authorized Official - Phone:773-415-1851
Mailing Address - Street 1:3654 N LAKEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613
Mailing Address - Country:US
Mailing Address - Phone:773-415-1851
Mailing Address - Fax:773-775-8126
Practice Address - Street 1:3654 N LAKEWOOD AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613
Practice Address - Country:US
Practice Address - Phone:773-415-1851
Practice Address - Fax:773-775-8126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01634480OtherBCBS