Provider Demographics
NPI:1366335317
Name:SANFORD, CHLOE ANN
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:ANN
Last Name:SANFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30923 SEA SPRITE DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60481-7713
Mailing Address - Country:US
Mailing Address - Phone:815-351-7624
Mailing Address - Fax:
Practice Address - Street 1:1554 CARVER CIR
Practice Address - Street 2:
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-4713
Practice Address - Country:US
Practice Address - Phone:814-937-9909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist