Individual ProviderKimberly Lay FraherSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address1530 North Maplewood Ave, Chicago, IL 60622(773) 782-3189(773) 592-6953PECOS EnrollmentBased on the most recent information from CMS, provider Kimberly Lay Fraher does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1770558660Provider TypeIndividualFull NameFraher, Kimberly LayTitleMs.CredentialM.ED., CCC-SLPGenderFemaleSole ProprietorYesEnumeration Date2/22/2006Last Updated4/7/2015Contact InformationPractice LocationPractice Address1530 North Maplewood Ave, Chicago, IL 60622Phone(773) 782-3189Fax(773) 782-3189Mailing LocationMailing Address1530 N Maplewood Ave, Chicago, IL 60622-1643Phone(773) 592-6953Fax(773) 435-6449Provider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense146-005843IllinoisProvider IdentifiersIDDescriptionIssuerID01632614DescriptionOtherIssuerBC/BS OF IL PROV #Illinois