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NPI Code Detail

MEDICARE: REBECCA KOPERA SLP

MEDICARE: REBECCA KOPERA SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist146.011971IL

General Provider Information

NPI Number : 1154861391
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA KOPERA SLP
Provider Business Mailing Address
First Line : 14711 S RAVINIA AVE
Second Line :
City : ORLAND PARK
State : IL
Zip : 60462-3100
Country : US
Telephone Number : 708-226-9200
Fax Number : 888-474-8137
Provider Business Practice Location Address
First Line : 14711 S RAVINIA AVE
Second Line :
City : ORLAND PARK
State : IL
Zip : 60462-3100
Country : US
Telephone Number : 708-226-9200
Fax Number : 888-474-8137
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2017
Last Update Date : 03/07/2017

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Directions to “ REBECCA KOPERA SLP” Practice Location

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