Provenzano, Deborah

Provenzano, Deborah is an individual health care provider with primary practice located at 9736 S Hamilton Ave , Chicago IL 60643-1644. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Assistant, which is considered as her primary health care specialty. Provenzano, Deborah can be contacted via phone (773) 343-8484.

Contact Information

Primary practice address
9736 S Hamilton Ave Chicago IL 60643-1644
Phone: (773) 343-8484
Fax: (773) 305-0954
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Assistant 2355S0801X Illinois

Profile Details

NPI number 1164548376
LBN Legal business name Provenzano, Deborah
Credentials SLPA
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164548376 NPPES
Illinois Other 01635583 BLUE CROSS BLUE SHIELD

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