Provider Demographics
NPI:1700059391
Name:CHAPMAN, COURTNEY BROOKE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:BROOKE
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:CHAPMAN
Other - Last Name:LEDERER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:3654 N. LAKEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613
Mailing Address - Country:US
Mailing Address - Phone:773-415-1851
Mailing Address - Fax:773-755-8126
Practice Address - Street 1:3654 N. LAKEWOOD AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613
Practice Address - Country:US
Practice Address - Phone:773-415-1851
Practice Address - Fax:773-755-8126
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-04
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146-005801235Z00000X
IL146005801235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist