MEDICARE: ANGELA N CHANDLEE 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
1	235Z00000X	Speech-Language Pathologist	146-010639	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	146-010639	OTHER	IL	IL LICENSE NO.

General Provider Information

NPI Number	:	1326358177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA N CHANDLEE SLP

Provider Business Mailing Address
First Line	:	716 MAIN ST
Second Line	:
City	:	NORTH HENDERSON
State	:	IL
Zip	:	61466-5046
Country	:	US
Telephone Number	:	847-814-7716
Fax Number	:

Provider Business Practice Location Address
First Line	:	716 MAIN ST
Second Line	:
City	:	NORTH HENDERSON
State	:	IL
Zip	:	61466-5046
Country	:	US
Telephone Number	:	847-814-7716
Fax Number	:

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

Provider Enumeration Date	:	10/14/2010
Last Update Date	:	05/02/2017

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Directions to “ ANGELA N CHANDLEE SLP” Practice Location

Language	Start Address	Practice Location

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