Kristy L Driscoll

Individual provider Active NPI Speech-Language Pathologist · Forest Park, IL

NPI 1013633544 · NPPES record last updated Nov 3, 2023

Key facts

NPI
1013633544
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
2416597 (IL)
Practice address
925 Beloit Ave
Forest Park, IL 60130-2301
Phone
(708) 979-0828
NPI assigned
Oct 17, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2416597ILMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2416597 IL Yes

Addresses

Primary practice location

925 Beloit Ave
Forest Park, IL 60130-2301

Mailing address

925 Beloit Ave
Forest Park, IL 60130-2301

Other providers in Forest Park, IL

All providers in Forest Park, IL · Speech-Language Pathologist in Illinois

Sources for this page

Verify at the official NPI Registry.