Healthcare Provider Details

I. General information

NPI: 1497918304
Provider Name (Legal Business Name): JEANNE WEN YEE M.A. CCC-SLP/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 01/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 S. WELLS ST #1503
CHICAGO IL
60607-4789
US

IV. Provider business mailing address

611 S. WELLS #1503
CHICAGO IL
60607-4789
US

V. Phone/Fax

Practice location:
  • Phone: 773-289-2239
  • Fax:
Mailing address:
  • Phone: 773-289-2239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number146.009009
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: