Provider Demographics
NPI:1891077517
Name:CHOLIS, AMY ANN
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:ANN
Last Name:CHOLIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3736 N SHEFFIELD AVE APT 2N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-5939
Mailing Address - Country:US
Mailing Address - Phone:708-261-2453
Mailing Address - Fax:
Practice Address - Street 1:3736 N SHEFFIELD AVE APT 2N
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-5939
Practice Address - Country:US
Practice Address - Phone:708-261-2453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146009840235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist