Healthcare Provider Details

I. General information

NPI: 1629602552
Provider Name (Legal Business Name): AMIE J PRYPUTNIEWICZ MS,CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/29/2020
Last Update Date: 02/29/2020
Certification Date: 02/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 OLD OAK RD
NORTH BARRINGTON IL
60010-2224
US

IV. Provider business mailing address

100 OLD OAK RD
NORTH BARRINGTON IL
60010-2224
US

V. Phone/Fax

Practice location:
  • Phone: 847-909-2658
  • Fax:
Mailing address:
  • Phone: 847-909-2658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number146008453
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: