Healthcare Provider Details

I. General information

NPI: 1679147714
Provider Name (Legal Business Name): REBECCA ANNE HUFNUS CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2021
Last Update Date: 05/13/2021
Certification Date: 05/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 LACEY RD
DOWNERS GROVE IL
60515-5430
US

IV. Provider business mailing address

4132 N OTTAWA AVE
NORRIDGE IL
60706-7221
US

V. Phone/Fax

Practice location:
  • Phone: 630-743-4500
  • Fax:
Mailing address:
  • Phone: 708-268-1154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number146.013929
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: