Healthcare Provider Details

I. General information

NPI: 1700704434
Provider Name (Legal Business Name): JULIA PERINE SLP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21654 S NADIA DR
JOLIET IL
60404-6697
US

IV. Provider business mailing address

21654 S NADIA DR
JOLIET IL
60404-6697
US

V. Phone/Fax

Practice location:
  • Phone: 815-823-2791
  • Fax:
Mailing address:
  • Phone: 815-823-2791
  • 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: JULIA PERINE
Title or Position: SPEECH-LANGUAGE PATHOLOGIST
Credential: M.A. CCC-SLP
Phone: 815-823-2791