Provider Demographics
NPI:1285777664
Name:VONBEHREN, ERICA LYNN (MA)
Entity type:Individual
Prefix:MS
First Name:ERICA
Middle Name:LYNN
Last Name:VONBEHREN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7436 W 153RD ST UNIT 3
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-6716
Mailing Address - Country:US
Mailing Address - Phone:773-716-4907
Mailing Address - Fax:
Practice Address - Street 1:19065 HICKORY CREEK PL
Practice Address - Street 2:SUITE 110
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-8507
Practice Address - Country:US
Practice Address - Phone:708-478-5400
Practice Address - Fax:708-478-5300
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
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