Provider Demographics
NPI:1194885947
Name:KLEPAC, DAHLIA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:DAHLIA
Middle Name:
Last Name:KLEPAC
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 N LINCOLN PARK W
Mailing Address - Street 2:32F
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-4780
Mailing Address - Country:US
Mailing Address - Phone:773-880-4855
Mailing Address - Fax:773-880-3904
Practice Address - Street 1:2300 N CHILDRENS PLZ
Practice Address - Street 2:BOX 148
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-3363
Practice Address - Country:US
Practice Address - Phone:773-880-4855
Practice Address - Fax:773-880-3904
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist