Provider Demographics
NPI:1215309877
Name:SEPT, ANDREA (MA, CCC-SLP/L)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:SEPT
Suffix:
Gender:F
Credentials:MA, CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 COVENTRY LN
Mailing Address - Street 2:SUITE 170
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-7579
Mailing Address - Country:US
Mailing Address - Phone:815-356-2700
Mailing Address - Fax:815-356-2703
Practice Address - Street 1:500 COVENTRY LN
Practice Address - Street 2:SUITE 170
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-7579
Practice Address - Country:US
Practice Address - Phone:815-356-2700
Practice Address - Fax:815-356-2703
Is Sole Proprietor?:No
Enumeration Date:2015-10-22
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.011278235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist