MEDICARE: CHRISTINE ANNE LOPREST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SP20269	CA
2	235Z00000X	Speech-Language Pathologist	146014021	IL

General Provider Information

NPI Number	:	1013424209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE ANNE LOPREST

Provider Business Mailing Address
First Line	:	1433 N CLEVELAND AVE APT F
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60610-1179
Country	:	US
Telephone Number	:	847-867-2037
Fax Number	:

Provider Business Practice Location Address
First Line	:	2211 N BURKE DR
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-3249
Country	:	US
Telephone Number	:	847-398-4275
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2018
Last Update Date	:	01/09/2018

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Directions to “ CHRISTINE ANNE LOPREST ” Practice Location

Language	Start Address	Practice Location

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