Healthcare Provider Details
I. General information
NPI: 1558612838
Provider Name (Legal Business Name): MARGARET HUTSON-NECHKASH SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/26/2012
Last Update Date: 09/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2423 GLENWOOD AVE
JOLIET IL
60435-5483
US
IV. Provider business mailing address
7040 BRIGHTON CT APT 102
WOODRIDGE IL
60517-2128
US
V. Phone/Fax
- Phone: 815-725-9992
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: