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NPI Code Detail

MEDICARE: ZACHARY STEPHEN CARMICHAEL M.S. CF-SLP

MEDICARE: ZACHARY STEPHEN CARMICHAEL M.S. 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
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1962149989
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZACHARY STEPHEN CARMICHAEL M.S. CF-SLP
Provider Business Mailing Address
First Line : 111 E ILLINOIS ST
Second Line :
City : NEW BADEN
State : IL
Zip : 62265-1850
Country : US
Telephone Number : 618-588-4924
Fax Number :
Provider Business Practice Location Address
First Line : 111 E ILLINOIS ST
Second Line :
City : NEW BADEN
State : IL
Zip : 62265-1850
Country : US
Telephone Number : 618-588-4924
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2022
Last Update Date : 05/20/2022

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