Provider Demographics
NPI:1972512150
Name:MCCAIN, AKILIA D T (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:AKILIA
Middle Name:D T
Last Name:MCCAIN
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 1:7226 INDIAN BOUNDARY
Mailing Address - Street 2:
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46403-1203
Mailing Address - Country:US
Mailing Address - Phone:219-939-8655
Mailing Address - Fax:219-939-8994
Practice Address - Street 1:10702 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-3136
Practice Address - Country:US
Practice Address - Phone:773-779-5800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146-006026235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL146-006026OtherSTATE LICENSE