Provider Demographics
NPI:1356034458
Name:ANDERSON, CHLOE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7251 RANDOLPH ST APT B2
Mailing Address - Street 2:
Mailing Address - City:FOREST PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60130-1332
Mailing Address - Country:US
Mailing Address - Phone:217-273-3103
Mailing Address - Fax:
Practice Address - Street 1:310 S MAIN ST STE D
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-2692
Practice Address - Country:US
Practice Address - Phone:630-652-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-02
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist