Healthcare Provider Details

I. General information

NPI: 1568923621
Provider Name (Legal Business Name): THE PLACE FOR SPEECH THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2019
Last Update Date: 07/05/2022
Certification Date: 07/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8609 W BRYN MAWR AVE
CHICAGO IL
60631-3524
US

IV. Provider business mailing address

8609 W BRYN MAWR AVE STE 204
CHICAGO IL
60631-3524
US

V. Phone/Fax

Practice location:
  • Phone: 773-644-7787
  • Fax: 224-241-3132
Mailing address:
  • Phone: 773-726-1416
  • Fax: 224-241-3132

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: MRS. ALLISON ONEIL
Title or Position: CEO
Credential:
Phone: 773-644-7787