Provider Demographics
NPI:1205695681
Name:BIENIEK, VERONICA LYNN
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:LYNN
Last Name:BIENIEK
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 1:110 E SCHUBERT AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60139-2077
Mailing Address - Country:US
Mailing Address - Phone:630-689-7568
Mailing Address - Fax:
Practice Address - Street 1:201 N FOREST CT
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-2918
Practice Address - Country:US
Practice Address - Phone:630-965-4208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.017605235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist