Provider Demographics
NPI:1649680323
Name:FORAND, ALYSSA VANPARIS (MHS)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:VANPARIS
Last Name:FORAND
Suffix:
Gender:F
Credentials:MHS
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:NICOLE
Other - Last Name:VAN PARIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1943 W OAKDALE AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-4025
Mailing Address - Country:US
Mailing Address - Phone:314-541-7477
Mailing Address - Fax:
Practice Address - Street 1:1943 W OAKDALE AVE APT 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-4025
Practice Address - Country:US
Practice Address - Phone:314-541-7477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-02
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146012377235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL146012377OtherILLINOIS DEPARTMENT OF PROFESSIONAL REGULATION