Healthcare Provider Details

I. General information

NPI: 1811636632
Provider Name (Legal Business Name): PAIGE ELIZABETH HUFFMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2022
Last Update Date: 06/07/2022
Certification Date: 06/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4433 W TOUHY AVE STE 335
LINCOLNWOOD IL
60712-1820
US

IV. Provider business mailing address

4433 W TOUHY AVE STE 335
LINCOLNWOOD IL
60712-1820
US

V. Phone/Fax

Practice location:
  • Phone: 877-486-4140
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number146.016528
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: