Kristian Cook
Individual provider Active NPI Speech-Language Pathologist · South Holland, IL
NPI 1699536631 · NPPES record last updated Jan 17, 2024
Key facts
- NPI
- 1699536631
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 242.007623 (IL)
- Practice address
- 525 E 162ND St
South Holland, IL 60473-2384 - Phone
- (708) 491-8861
- NPI assigned
- Jan 17, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 242.007623 | IL | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 242.007623 | IL | Yes |
Addresses
Primary practice location
525 E 162ND St
South Holland, IL 60473-2384
Mailing address
525 E 162ND St
South Holland, IL 60473-2384
Phone (708) 491-8861
Other providers in South Holland, IL
- Ronald Thomas Coleman Sr.
- Betsy Colvin
- Complete Home Health Services, Inc
- Carlos Concepcion
- Conscientious Incorporated
- Natanya Cooper
- Christopher Corazzi
- Cornerstone Services, Inc
- Cornerstone Services, Inc
- Nicole Margaret Couri
All providers in South Holland, IL · Speech-Language Pathologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.