Provider Demographics
NPI:1720771793
Name:SERRATO, CAROLINA
Entity Type:Individual
Prefix:
First Name:CAROLINA
Middle Name:
Last Name:SERRATO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 E 30TH PL
Mailing Address - Street 2:
Mailing Address - City:STEGER
Mailing Address - State:IL
Mailing Address - Zip Code:60475-1131
Mailing Address - Country:US
Mailing Address - Phone:708-674-5019
Mailing Address - Fax:
Practice Address - Street 1:29 E 30TH PL
Practice Address - Street 2:
Practice Address - City:STEGER
Practice Address - State:IL
Practice Address - Zip Code:60475-1131
Practice Address - Country:US
Practice Address - Phone:708-674-5019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242006851235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist