MEDICARE: ERIKA MARY FENSTAD

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		IL

General Provider Information

NPI Number	:	1831061621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIKA MARY FENSTAD

Provider Business Mailing Address
First Line	:	834 W BRADLEY PL APT 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-5177
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	834 W BRADLEY PL APT 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-5177
Country	:	US
Telephone Number	:	320-333-4346
Fax Number	:

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

Provider Enumeration Date	:	09/22/2025
Last Update Date	:	09/22/2025

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Directions to “ ERIKA MARY FENSTAD ” Practice Location

Language	Start Address	Practice Location

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