Provider Demographics
NPI:1588899611
Name:EGAN, SYLVIA M (MS,CCC)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:M
Last Name:EGAN
Suffix:
Gender:F
Credentials:MS,CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16442 LEE AVE
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-5357
Mailing Address - Country:US
Mailing Address - Phone:708-226-0944
Mailing Address - Fax:
Practice Address - Street 1:14601JOHN HUMPHREY DRIVE
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462
Practice Address - Country:US
Practice Address - Phone:708-349-8300
Practice Address - Fax:708-460-5136
Is Sole Proprietor?:No
Enumeration Date:2009-05-19
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146003472235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist