MEDICARE: MRS. JONI PRIHODA MS 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	146-008654	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1617235	OTHER	IL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1972621498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JONI PRIHODA MS CCC-SLP

Provider Business Mailing Address
First Line	:	4400 BRITTANY DR
Second Line	:
City	:	ZIONSVILLE
State	:	IN
Zip	:	46077-8224
Country	:	US
Telephone Number	:	812-449-0953
Fax Number	:

Provider Business Practice Location Address
First Line	:	534 W CORNELIA AVE
Second Line	:	APT 3N
City	:	CHICAGO
State	:	IL
Zip	:	60657-2746
Country	:	US
Telephone Number	:	773-857-2408
Fax Number	:	312-275-8499

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

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	05/18/2022

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Directions to “ MRS. JONI PRIHODA MS CCC-SLP” Practice Location

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