Provider Demographics
NPI:1215445929
Name:SIMAK, KRISTINA (MA, CCC-SLP/L)
Entity type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:
Last Name:SIMAK
Suffix:
Gender:F
Credentials:MA, CCC-SLP/L
Other - Prefix:MS
Other - First Name:KRISTINA
Other - Middle Name:
Other - Last Name:CVETKOVIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP/L
Mailing Address - Street 1:9311 SHIELDS AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60513-1825
Mailing Address - Country:US
Mailing Address - Phone:708-215-6106
Mailing Address - Fax:
Practice Address - Street 1:9311 SHIELDS AVE
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:IL
Practice Address - Zip Code:60513-1825
Practice Address - Country:US
Practice Address - Phone:708-215-6106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-16
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist