Provider Demographics
NPI:1912767633
Name:NAUGHTON, ERIN A (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:A
Last Name:NAUGHTON
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:ANNE
Other - Last Name:NAUGHTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:728 W JACKSON BLVD APT 105
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-5400
Mailing Address - Country:US
Mailing Address - Phone:847-909-2672
Mailing Address - Fax:
Practice Address - Street 1:728 W JACKSON BLVD APT 105
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60661-5400
Practice Address - Country:US
Practice Address - Phone:847-909-2672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146006789235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty