Most Relevant Information
Provider Data
| NPI Number: | 1003635525 |
| Provider Name: | KORTNEY BANKS M.S CCC-SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 146017754 |
Most Important Dates
| Enumeration Date: | 10/10/2024 |
| Last Updated: | 10/10/2024 |
Provider Practice Location
1301 W COSSITT AVE
LA GRANGE
IL
605252145
Practice Location Phone/Fax
| Phone: | 7083545730 |
| Fax: |
Provider Mailing Location
1914 S 15TH AVE APT 2W
BROADVIEW
IL
601553084
Provider Mailing Phone/Fax
| Phone: | 3196770595 |
| Fax: |