Provider Demographics
NPI:1487096608
Name:TEPE, CAITLIN M (MS)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:M
Last Name:TEPE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2142 N HALSTED ST APT 4F
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-4325
Mailing Address - Country:US
Mailing Address - Phone:574-217-5625
Mailing Address - Fax:
Practice Address - Street 1:2142 N HALSTED ST APT 4F
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-4325
Practice Address - Country:US
Practice Address - Phone:574-217-5625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist