MEDICARE: MRS. ALLISON MARIE OSWALD 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
1	235Z00000X	Speech-Language Pathologist	146009395	IL

General Provider Information

NPI Number	:	1639338296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALLISON MARIE OSWALD CCC-SLP

Provider Business Mailing Address
First Line	:	103 GOLFVIEW DR
Second Line	:
City	:	GLENDALE HTS
State	:	IL
Zip	:	60139-3674
Country	:	US
Telephone Number	:	815-953-0811
Fax Number	:	630-682-1484

Provider Business Practice Location Address
First Line	:	103 GOLFVIEW DR
Second Line	:
City	:	GLENDALE HTS
State	:	IL
Zip	:	60139-3674
Country	:	US
Telephone Number	:	815-953-0811
Fax Number	:	630-682-1484

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

Provider Enumeration Date	:	06/08/2008
Last Update Date	:	08/11/2008

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