MEDICARE: MEGAN MCKENNA M.A., CCC-SLP/L

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
1	235Z00000X	Speech-Language Pathologist	146.012336	IL

General Provider Information

NPI Number	:	1275959850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN MCKENNA M.A., CCC-SLP/L

Provider Business Mailing Address
First Line	:	98 SAINT GERMAIN PL
Second Line	:
City	:	ST CHARLES
State	:	IL
Zip	:	60175-4606
Country	:	US
Telephone Number	:	815-353-8057
Fax Number	:

Provider Business Practice Location Address
First Line	:	98 SAINT GERMAIN PL
Second Line	:
City	:	ST CHARLES
State	:	IL
Zip	:	60175-4606
Country	:	US
Telephone Number	:	815-353-8057
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2014
Last Update Date	:	06/14/2024

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