Provider Demographics
NPI:1407186182
Name:FRITZ, CAITLIN (CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:CAITLIN
Middle Name:
Last Name:FRITZ
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1518 OAK AVE
Mailing Address - Street 2:APT 1N
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-4213
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1518 OAK AVE
Practice Address - Street 2:APT 1N
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4213
Practice Address - Country:US
Practice Address - Phone:434-227-6226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-02
Last Update Date:2010-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146009596235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist