Provider Demographics
NPI:1972499887
Name:PATINO, AUTUMN (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:AUTUMN
Middle Name:
Last Name:PATINO
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 1:3172 W MEADOW LANE DR
Mailing Address - Street 2:
Mailing Address - City:MERRIONETTE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60803-5813
Mailing Address - Country:US
Mailing Address - Phone:708-937-5238
Mailing Address - Fax:
Practice Address - Street 1:18410 GOVERNORS HWY
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-2911
Practice Address - Country:US
Practice Address - Phone:708-852-2535
Practice Address - Fax:708-679-2634
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist