Provider Demographics
NPI:1386427672
Name:CHAVKIN, MARLI JACLYN (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:MARLI
Middle Name:JACLYN
Last Name:CHAVKIN
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-2357
Mailing Address - Country:US
Mailing Address - Phone:847-969-5977
Mailing Address - Fax:844-668-4621
Practice Address - Street 1:807 CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-2357
Practice Address - Country:US
Practice Address - Phone:847-969-5977
Practice Address - Fax:844-668-4621
Is Sole Proprietor?:No
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist