Provider Demographics
NPI:1144839242
Name:BIRGER, SHANA
Entity type:Individual
Prefix:
First Name:SHANA
Middle Name:
Last Name:BIRGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:942 W SHERIDAN RD APT 3A
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-6487
Mailing Address - Country:US
Mailing Address - Phone:847-208-3556
Mailing Address - Fax:
Practice Address - Street 1:942 W SHERIDAN RD APT 3A
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-6487
Practice Address - Country:US
Practice Address - Phone:847-208-3556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-24
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.005899235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist