Provider Demographics
NPI:1861247637
Name:LATKA, CHLOE
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:
Last Name:LATKA
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 1:501 STEVENSON DR
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-2534
Mailing Address - Country:US
Mailing Address - Phone:719-209-9810
Mailing Address - Fax:
Practice Address - Street 1:960 STATE ROUTE 22 STE 216
Practice Address - Street 2:
Practice Address - City:FOX RIVER GROVE
Practice Address - State:IL
Practice Address - Zip Code:60021-1955
Practice Address - Country:US
Practice Address - Phone:224-219-1924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist