Provider Demographics
NPI:1023143286
Name:HILL, KRISTINE RENEE
Entity type:Individual
Prefix:MRS
First Name:KRISTINE
Middle Name:RENEE
Last Name:HILL
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 1:21464 S REDWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SHOREWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60404-7543
Mailing Address - Country:US
Mailing Address - Phone:708-310-1102
Mailing Address - Fax:
Practice Address - Street 1:21464 S REDWOOD LN
Practice Address - Street 2:
Practice Address - City:SHOREWOOD
Practice Address - State:IL
Practice Address - Zip Code:60404-7543
Practice Address - Country:US
Practice Address - Phone:708-310-1102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
IL146-007887235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist