Provider Demographics
NPI:1922247014
Name:KHATTARY, NOEL (MA,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:NOEL
Middle Name:
Last Name:KHATTARY
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 INDIAN DR
Mailing Address - Street 2:
Mailing Address - City:CLARENDON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60514-1120
Mailing Address - Country:US
Mailing Address - Phone:513-673-2282
Mailing Address - Fax:
Practice Address - Street 1:120 INDIAN DR
Practice Address - Street 2:
Practice Address - City:CLARENDON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60514-1120
Practice Address - Country:US
Practice Address - Phone:513-673-2282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.008373235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist