Healthcare Provider Details

I. General information

NPI: 1821913831
Provider Name (Legal Business Name): REBECCA JEAN LUEDTKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 SHEEHAN AVE
GLEN ELLYN IL
60137-6369
US

IV. Provider business mailing address

290 TOWN CENTER LN
GLENDALE HEIGHTS IL
60139-1700
US

V. Phone/Fax

Practice location:
  • Phone: 630-247-5086
  • Fax:
Mailing address:
  • Phone: 630-942-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: