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NPI Code Detail

MEDICARE: THERESE BROWN CCC-SLP

MEDICARE:   THERESE  BROWN  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 Pathologist242003147IL
2235Z00000XSpeech-Language Pathologist146012990IL

General Provider Information

NPI Number : 1306252424
Entity Type Code : Individual
Provider Name (Legal Business Name) : THERESE BROWN CCC-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 : 815-469-1500
Fax Number :
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 : 815-469-1500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2014
Last Update Date : 04/11/2022

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Directions to “ THERESE BROWN CCC-SLP” Practice Location

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