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NPI Code Detail

MEDICARE: SYLVIA CAMPBELL CCC-SLP

MEDICARE: SYLVIA CAMPBELL CCC-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 Pathologist146.008980IL

General Provider Information

NPI Number : 1205061405
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYLVIA CAMPBELL CCC-SLP
Provider Business Mailing Address
First Line : 4167 BIVERTON DR
Second Line :
City : SWANSEA
State : IL
Zip : 62226-2162
Country : US
Telephone Number : 618-416-2636
Fax Number :
Provider Business Practice Location Address
First Line : 3354 JEROME LN
Second Line : THERAPY DEPARTMENT
City : CAHOKIA
State : IL
Zip : 62206-2604
Country : US
Telephone Number : 618-337-9400
Fax Number : 618-332-1811
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2009
Last Update Date : 05/18/2009

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Directions to “ SYLVIA CAMPBELL CCC-SLP” Practice Location

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