Provider Demographics
NPI:1699972117
Name:CUNNINGHAM, SARAH ELIANE (MA, CCC SLPL)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIANE
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:MA, CCC SLPL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:668 EXMOOR CT
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-7006
Mailing Address - Country:US
Mailing Address - Phone:815-354-7551
Mailing Address - Fax:
Practice Address - Street 1:15 COMMERCE DR
Practice Address - Street 2:SUITE 116
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-7807
Practice Address - Country:US
Practice Address - Phone:847-223-7433
Practice Address - Fax:847-223-7435
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
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