Healthcare Provider Details

I. General information

NPI: 1033963970
Provider Name (Legal Business Name): BESTFEEDINGS AND SPEECH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2024
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1812 TRAILS EDGE DR
NORTHBROOK IL
60062
US

IV. Provider business mailing address

1812 TRAILS EDGE DR
NORTHBROOK IL
60062
US

V. Phone/Fax

Practice location:
  • Phone: 847-220-7411
  • Fax:
Mailing address:
  • Phone: 847-220-7411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number StateNULL

VIII. Authorized Official

Name: ALLISON GRAY
Title or Position: OWNER
Credential: MA CCC-SLP/L, IBCLC
Phone: 847-220-7411