Provider Demographics
NPI:1881837920
Name:PAYNE, CAREY MEREDITH III (MCD, CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:CAREY
Middle Name:MEREDITH
Last Name:PAYNE
Suffix:III
Gender:M
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 UNIVERSITY LN
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-2798
Mailing Address - Country:US
Mailing Address - Phone:847-985-9581
Mailing Address - Fax:
Practice Address - Street 1:261 UNIVERSITY LN
Practice Address - Street 2:
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-2798
Practice Address - Country:US
Practice Address - Phone:847-985-9581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.006468235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist