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General NPI Number Information
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NPI Number | 1396904751
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Entity Type | Individual
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Provider Name | SHAHEEN THASON
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Gender | Female
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Dates
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Enumeration Date | 06/02/2008
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Last Update Date | 03/20/2020
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Provider Practice Location Address
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Address Line | 4425 W 63RD ST
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City | CHICAGO
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State | IL
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Zip | 60629-5530
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Country | US
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Telephone | 773-585-8244
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 PINEWOOD DR
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City | DOWNERS GROVE
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State | IL
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Zip | 60516-3859
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Country | US
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Telephone | 773-960-1683
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 146-007395
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License Number State | IL
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