MEDICARE: JULIE A OBERBROECKLING 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	146006766	IL

General Provider Information

NPI Number	:	1831383975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE A OBERBROECKLING SLP

Provider Business Mailing Address
First Line	:	825 N CASS AVE STE 109
Second Line	:
City	:	WESTMONT
State	:	IL
Zip	:	60559-6401
Country	:	US
Telephone Number	:	773-318-8890
Fax Number	:	630-568-5938

Provider Business Practice Location Address
First Line	:	825 N CASS AVE STE 109
Second Line	:
City	:	WESTMONT
State	:	IL
Zip	:	60559-6401
Country	:	US
Telephone Number	:	773-318-8890
Fax Number	:

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

Provider Enumeration Date	:	08/31/2007
Last Update Date	:	01/21/2019

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Directions to “ JULIE A OBERBROECKLING SLP” Practice Location

Language	Start Address	Practice Location

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