Healthcare Provider Details

I. General information

NPI: 1639059470
Provider Name (Legal Business Name): JOANNA SKORUPA
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2025
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S SPRINGINSGUTH RD
SCHAUMBURG IL
60193-2499
US

IV. Provider business mailing address

670 E GOLF RD
DES PLAINES IL
60016-2309
US

V. Phone/Fax

Practice location:
  • Phone: 847-357-5900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: