Provider Demographics
NPI:1497878169
Name:KRISTIN MORAN SPEECH ASSOCIATES, LLC
Entity type:Organization
Organization Name:KRISTIN MORAN SPEECH ASSOCIATES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MORAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:773-750-9947
Mailing Address - Street 1:1806 W ARGYLE ST
Mailing Address - Street 2:UNIT H
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-3398
Mailing Address - Country:US
Mailing Address - Phone:773-750-9947
Mailing Address - Fax:773-561-7821
Practice Address - Street 1:1806 W ARGYLE ST
Practice Address - Street 2:UNIT H
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-3398
Practice Address - Country:US
Practice Address - Phone:773-750-9947
Practice Address - Fax:773-561-7821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty