Healthcare Provider Details

I. General information

NPI: 1629717541
Provider Name (Legal Business Name): PAIGE FUHRMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2022
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 ILLINI DR
BELLEVILLE IL
62223-3322
US

IV. Provider business mailing address

510 WESTERN AVE
COLLINSVILLE IL
62234-2026
US

V. Phone/Fax

Practice location:
  • Phone: 618-538-6114
  • Fax:
Mailing address:
  • Phone: 618-301-8669
  • 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: