Healthcare Provider Details

I. General information

NPI: 1295914109
Provider Name (Legal Business Name): LITTLE CHATTERBOX, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2007
Last Update Date: 10/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4735 N LAPORTE AVE
CHICAGO IL
60630-3830
US

IV. Provider business mailing address

4735 N LAPORTE AVE
CHICAGO IL
60630-3830
US

V. Phone/Fax

Practice location:
  • Phone: 773-817-8743
  • Fax:
Mailing address:
  • Phone: 773-817-8743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateIL

VIII. Authorized Official

Name: MRS. TORI R. NGUYEN
Title or Position: SPEECH-LANGUAGE PATHOLOGIST
Credential: M.S., CCC-SLP/L
Phone: 773-817-8743