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NPI Code Detail

MEDICARE: ELIZABETH NIELSEN SLP

MEDICARE:   ELIZABETH  NIELSEN  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 Pathologist146011731IL

General Provider Information

NPI Number : 1487916029
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH NIELSEN SLP
Provider Business Mailing Address
First Line : 601 E GARFIELD ST
Second Line :
City : WATERMAN
State : IL
Zip : 60556-9861
Country : US
Telephone Number : 815-508-8327
Fax Number :
Provider Business Practice Location Address
First Line : 601 E GARFIELD ST
Second Line :
City : WATERMAN
State : IL
Zip : 60556-9861
Country : US
Telephone Number : 815-508-8327
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2012
Last Update Date : 06/26/2014

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Directions to “ ELIZABETH NIELSEN SLP” Practice Location

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