Provider Demographics
NPI:1548277908
Name:CHIAMPAS, CASSANDRA (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:
Last Name:CHIAMPAS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:298 N BERTEAU AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2412
Mailing Address - Country:US
Mailing Address - Phone:630-201-4583
Mailing Address - Fax:
Practice Address - Street 1:298 N BERTEAU AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-2412
Practice Address - Country:US
Practice Address - Phone:630-834-0331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146003998235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2232835OtherBLUE CROSS BLUE SHIELD