Provider Demographics
NPI:1255819710
Name:KEMPIAK, COURTNEY (MA, CF-SLP)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:KEMPIAK
Suffix:
Gender:F
Credentials:MA, CF-SLP
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:BENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3941 E 30TH RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:IL
Mailing Address - Zip Code:60541
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10 SARAVANOS RD
Practice Address - Street 2:
Practice Address - City:YORKVILLE
Practice Address - State:IL
Practice Address - Zip Code:60560-5814
Practice Address - Country:US
Practice Address - Phone:630-553-8444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-06
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.004816235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist