MEDICARE: MRS. CAROL E APEL MA SLP/LCCC

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	146.002103	IL

General Provider Information

NPI Number	:	1588844120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAROL E APEL MA SLP/LCCC

Provider Business Mailing Address
First Line	:	345 W DICKENS AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-4645
Country	:	US
Telephone Number	:	773-935-5917
Fax Number	:	773-935-5917

Provider Business Practice Location Address
First Line	:	345 W DICKENS AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-4645
Country	:	US
Telephone Number	:	773-935-5917
Fax Number	:	773-935-5917

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

Provider Enumeration Date	:	11/12/2007
Last Update Date	:	11/12/2007

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