Healthcare Provider Details

I. General information

NPI: 1679726392
Provider Name (Legal Business Name): SONIA LAMBAJIAN MS/CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2008
Last Update Date: 10/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2738 W NORTH AVE
CHICAGO IL
60647-9500
US

IV. Provider business mailing address

2738 W NORTH AVE
CHICAGO IL
60647-9500
US

V. Phone/Fax

Practice location:
  • Phone: 773-770-6500
  • Fax: 773-292-9381
Mailing address:
  • Phone: 773-770-6500
  • Fax: 773-292-9381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number146.009044
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: