Provider Demographics
NPI:1871666206
Name:LENDRAITIS, LINA A (MS, CCC-SLPL)
Entity Type:Individual
Prefix:
First Name:LINA
Middle Name:A
Last Name:LENDRAITIS
Suffix:
Gender:F
Credentials:MS, CCC-SLPL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 WASHINGTON BLVD APT 2
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-4928
Mailing Address - Country:US
Mailing Address - Phone:708-466-2211
Mailing Address - Fax:
Practice Address - Street 1:720 LAKE ST
Practice Address - Street 2:SUITE 201
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1424
Practice Address - Country:US
Practice Address - Phone:708-466-2211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.008203235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist