Provider Demographics
NPI:1851802425
Name:STANEVICIUS, LORI A (MHS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:A
Last Name:STANEVICIUS
Suffix:
Gender:F
Credentials:MHS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10480 NEBRASKA ST
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-2235
Mailing Address - Country:US
Mailing Address - Phone:815-460-3366
Mailing Address - Fax:
Practice Address - Street 1:10480 NEBRASKA ST
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-2235
Practice Address - Country:US
Practice Address - Phone:815-460-3366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-23
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist