Healthcare Provider Details

I. General information

NPI: 1861999575
Provider Name (Legal Business Name): ANNA GEBARDT MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA NERI MS, CCC-SLP

II. Dates (important events)

Enumeration Date: 04/09/2018
Last Update Date: 01/23/2023
Certification Date: 01/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2123 S ARLINGTON HEIGHTS RD
ARLINGTON HEIGHTS IL
60005-4105
US

IV. Provider business mailing address

830 S ADDISON AVE
VILLA PARK IL
60181
US

V. Phone/Fax

Practice location:
  • Phone: 847-593-4300
  • Fax:
Mailing address:
  • Phone: 630-620-4433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: