Provider Demographics
NPI:1487095352
Name:CHLEBEK, SARAH R (CCC-SLP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:R
Last Name:CHLEBEK
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 W RACE AVE
Mailing Address - Street 2:APT 1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-6249
Mailing Address - Country:US
Mailing Address - Phone:219-363-8498
Mailing Address - Fax:855-646-9309
Practice Address - Street 1:1903 W RACE AVE
Practice Address - Street 2:APT 1
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-6249
Practice Address - Country:US
Practice Address - Phone:219-363-8498
Practice Address - Fax:855-646-9309
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-08
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.012202235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist