Healthcare Provider Details

I. General information

NPI: 1477570422
Provider Name (Legal Business Name): TLC SPEECH SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 W BURLINGTON DR
MAPLE PARK IL
60151
US

IV. Provider business mailing address

309 W BURLINGTON DR
MAPLE PARK IL
60151
US

V. Phone/Fax

Practice location:
  • Phone: 630-853-6012
  • Fax: 815-827-3792
Mailing address:
  • Phone: 630-853-6012
  • Fax: 815-827-3792

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: MRS. TERRI LYNN ROBINSON
Title or Position: PRESIDENT
Credential: MA CCC-SLP
Phone: 630-853-6012