Provider Demographics
NPI:1770600546
Name:MITCHELL, CYNTHIA M (CCC SLP)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:M
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:CCC SLP
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:M
Other - Last Name:PARTYKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC SLP
Mailing Address - Street 1:6537 ROYAL GLEN CT
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-3321
Mailing Address - Country:US
Mailing Address - Phone:630-848-0297
Mailing Address - Fax:
Practice Address - Street 1:6537 ROYAL GLEN CT
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-3321
Practice Address - Country:US
Practice Address - Phone:630-848-0297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-25
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146003067235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist