Provider Demographics
NPI:1366134041
Name:FELLER, STEPHANIE LAUREN (AUD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:LAUREN
Last Name:FELLER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 W GEORGE ST APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-5134
Mailing Address - Country:US
Mailing Address - Phone:845-521-6094
Mailing Address - Fax:
Practice Address - Street 1:3000 N HALSTED ST STE 400
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-8480
Practice Address - Country:US
Practice Address - Phone:773-296-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist