Provider Demographics
NPI:1003307349
Name:CHISERI, ERIN RENEE (MA CCC- SLP)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:RENEE
Last Name:CHISERI
Suffix:
Gender:F
Credentials:MA CCC- SLP
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:RENEE
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCC-SLP
Mailing Address - Street 1:1500 STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-3867
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1500 STEWART AVE
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-3867
Practice Address - Country:US
Practice Address - Phone:847-318-4360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist