MEDICARE: MRS. SARAH CARFRAE SHEVLIN MS CCC SLP L

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	146006382	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01628130	OTHER	IL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1235137399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SARAH CARFRAE SHEVLIN MS CCC SLP L

Provider Business Mailing Address
First Line	:	7807 W GLENLAKE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60631-3804
Country	:	US
Telephone Number	:	773-680-0942
Fax Number	:

Provider Business Practice Location Address
First Line	:	7807 W GLENLAKE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60631-3804
Country	:	US
Telephone Number	:	773-680-0942
Fax Number	:	773-751-5091

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

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	10/12/2012

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Directions to “ MRS. SARAH CARFRAE SHEVLIN MS CCC SLP L” Practice Location

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