Provider Demographics
NPI:1437970563
Name:CHRISTOFOROU, ANDRIANI
Entity type:Individual
Prefix:
First Name:ANDRIANI
Middle Name:
Last Name:CHRISTOFOROU
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 1:650 VERSAILLES CIR UNIT A
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-3569
Mailing Address - Country:US
Mailing Address - Phone:847-922-9358
Mailing Address - Fax:
Practice Address - Street 1:8701 MENARD AVE
Practice Address - Street 2:
Practice Address - City:MORTON GROVE
Practice Address - State:IL
Practice Address - Zip Code:60053-3052
Practice Address - Country:US
Practice Address - Phone:847-965-9040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.017808235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist