Healthcare Provider Details

I. General information

NPI: 1730005224
Provider Name (Legal Business Name): ABIGAIL VANNATTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 S MAIN ST STE D
LOMBARD IL
60148-2692
US

IV. Provider business mailing address

520 N KINGSBURY ST UNIT 3104
CHICAGO IL
60654-8777
US

V. Phone/Fax

Practice location:
  • Phone: 630-652-0200
  • Fax:
Mailing address:
  • Phone: 765-760-4141
  • 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: