MEDICARE: CASSANDRA AMBERGER M.A., 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
1	235Z00000X	Speech-Language Pathologist	242006646	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487399275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSANDRA AMBERGER M.A., CF-SLP

Provider Business Mailing Address
First Line	:	PO BOX 399
Second Line	:
City	:	NORRIS CITY
State	:	IL
Zip	:	62869-0399
Country	:	US
Telephone Number	:	618-378-3212
Fax Number	:	618-378-3902

Provider Business Practice Location Address
First Line	:	580 U.S. HWY 45 S.
Second Line	:
City	:	NORRIS CITY
State	:	IL
Zip	:	62869-0399
Country	:	US
Telephone Number	:	618-378-3212
Fax Number	:	618-378-3902

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

Provider Enumeration Date	:	05/05/2022
Last Update Date	:	05/05/2022

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Directions to “ CASSANDRA AMBERGER M.A., CF-SLP” Practice Location

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