Provider Demographics
NPI:1457972705
Name:ESTAND, MICHELLE E (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:E
Last Name:ESTAND
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9137 S SPAULDING AVE
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60805-1551
Mailing Address - Country:US
Mailing Address - Phone:708-636-7263
Mailing Address - Fax:
Practice Address - Street 1:8200 185TH, TINLEY PARK, IL 60487, SUITE A/B, SUITE A/B
Practice Address - Street 2:SUITE A/B
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60487
Practice Address - Country:US
Practice Address - Phone:708-580-0440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-28
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist