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General NPI Number Information
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NPI Number | 1437200102
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Entity Type | Individual
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Provider Name | KERI JO THOMPSON MA, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | E 65TH STREET AT LAKE MICHIGAN
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City | CHICAGO
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State | IL
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Zip | 60649
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Country | US
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Telephone | 773-256-5788
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Fax |
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Provider Business Mailing Address
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Address Line | 426 W BARRY AVE UNIT 307
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City | CHICAGO
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State | IL
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Zip | 60657-5546
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Country | US
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Telephone |
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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 |
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License Number State | IL
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