Individual
MRS. JACQUELINE FAIRBANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC MS/L
Contact information
Practice address
40 E DUNDEE RD, BARRINGTON, IL 60010-5227
(224) 770-4339
Mailing address
22382 N RICHMOND CT, KILDEER, IL 60047-7948
(815) 742-0890
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146012836
IL
Other
Enumeration date
11/15/2021
Last updated
01/23/2023
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