Healthcare Provider Details

I. General information

NPI: 1023729027
Provider Name (Legal Business Name): BABBLES SPEECH THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2022
Last Update Date: 12/09/2022
Certification Date: 12/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24118 S INDIAN TRL
MANHATTAN IL
60442-8435
US

IV. Provider business mailing address

24118 S INDIAN TRL
MANHATTAN IL
60442-8435
US

V. Phone/Fax

Practice location:
  • Phone: 708-935-3596
  • Fax: 815-478-0481
Mailing address:
  • Phone: 708-935-3596
  • Fax: 815-478-0481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. CORINNE ANN JEZIORSKI
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: SLP
Phone: 708-935-3596