Individual
JANE ELISE SHOCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
7801 W 75TH ST, BRIDGEVIEW, IL 60455-1288
(708) 496-8722
Mailing address
17 STRATFORD CT, INDIAN HEAD PARK, IL 60525-4456
(630) 915-4012
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01110196
ASHA
IL
Enumeration date
05/14/2019
Last updated
05/14/2019
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