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NPI Code Detail

MEDICARE: KRISTIN SHARON STOICK M.S., CCC-SLP

MEDICARE: KRISTIN SHARON STOICK M.S., CCC-SLP
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
1235Z00000XSpeech-Language Pathologist111415TX
2235Z00000XSpeech-Language Pathologist146.013641IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1146.013641OTHERILSTATE LICENSE
2111415OTHERTXSTATE LICENSE

General Provider Information

NPI Number : 1043765993
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN SHARON STOICK M.S., CCC-SLP
Provider Business Mailing Address
First Line : 2706 N FRANCISCO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-1706
Country : US
Telephone Number : 713-294-0718
Fax Number :
Provider Business Practice Location Address
First Line : 3709 N KEDZIE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60618-4503
Country : US
Telephone Number : 773-377-5492
Fax Number : 773-303-8422
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2016
Last Update Date : 03/05/2019

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