Healthcare Provider Details

I. General information

NPI: 1982481107
Provider Name (Legal Business Name): BILINGUAL AND BRILLIANT SPEECH THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2023
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5120 S PARKSIDE AVE
CHICAGO IL
60638-1522
US

IV. Provider business mailing address

5120 S PARKSIDE AVE
CHICAGO IL
60638-1522
US

V. Phone/Fax

Practice location:
  • Phone: 312-731-8507
  • Fax:
Mailing address:
  • Phone: 312-731-8507
  • 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: MISS ESMERALDA V SANCHEZ
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: M.A CCC-SLP/L
Phone: 312-731-8507