Provider Demographics
NPI:1811408941
Name:PAPROCKI, KRISTIE SUE (SLP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIE
Middle Name:SUE
Last Name:PAPROCKI
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 W 124TH ST
Mailing Address - Street 2:
Mailing Address - City:CALUMET PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60827-5831
Mailing Address - Country:US
Mailing Address - Phone:708-824-3090
Mailing Address - Fax:
Practice Address - Street 1:1441 W 124TH ST
Practice Address - Street 2:
Practice Address - City:CALUMET PARK
Practice Address - State:IL
Practice Address - Zip Code:60827-5831
Practice Address - Country:US
Practice Address - Phone:708-824-3090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2093289235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist