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NPI Code Detail

MEDICARE: EMILY WITHAM M.S. CF-SLP

MEDICARE: EMILY WITHAM M.S. CF-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 Pathologist242.005803IL

General Provider Information

NPI Number : 1154930592
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY WITHAM M.S. CF-SLP
Provider Business Mailing Address
First Line : 400 N MCCLURG CT APT 2004
Second Line :
City : CHICAGO
State : IL
Zip : 60611-4375
Country : US
Telephone Number : 231-740-7798
Fax Number :
Provider Business Practice Location Address
First Line : 8 S MICHIGAN AVE STE 2100
Second Line :
City : CHICAGO
State : IL
Zip : 60603-3337
Country : US
Telephone Number : 312-392-1640
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2020
Last Update Date : 07/30/2020

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Directions to “ EMILY WITHAM M.S. CF-SLP” Practice Location

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