Provider Demographics
NPI:1538431846
Name:STUMPF, AMY MARIE (MS CCC-SLP/L)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:MARIE
Last Name:STUMPF
Suffix:
Gender:F
Credentials:MS CCC-SLP/L
Other - Prefix:MISS
Other - First Name:AMY
Other - Middle Name:MARIE
Other - Last Name:KRASOVECH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2836 ALANDALE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-1135
Mailing Address - Country:US
Mailing Address - Phone:630-779-1897
Mailing Address - Fax:
Practice Address - Street 1:1864 HIGH GROVE LN #122
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-9310
Practice Address - Country:US
Practice Address - Phone:708-478-1820
Practice Address - Fax:708-231-7248
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-01
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.010666235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist