Provider Demographics
NPI:1194076802
Name:FLICEK, CAITLIN MARIE (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:MARIE
Last Name:FLICEK
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MS
Other - First Name:CAITLIN
Other - Middle Name:MARIE
Other - Last Name:SCALIATINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2160 S 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:MAYWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60153-3328
Mailing Address - Country:US
Mailing Address - Phone:877-216-5437
Mailing Address - Fax:
Practice Address - Street 1:1S224 SUMMIT AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-3983
Practice Address - Country:US
Practice Address - Phone:877-216-5437
Practice Address - Fax:630-935-6990
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-21
Last Update Date:2012-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146010681235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist