Provider Demographics
NPI:1205307105
Name:PAVLOVICH, CLAIRE (MS CF-SLP)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:PAVLOVICH
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1367 N MOHAWK ST APT 1N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-1713
Mailing Address - Country:US
Mailing Address - Phone:913-205-4215
Mailing Address - Fax:
Practice Address - Street 1:3350 W SALT CREEK LN STE 115
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-1089
Practice Address - Country:US
Practice Address - Phone:847-757-2815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.005122235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist