Healthcare Provider Details
I. General information
NPI: 1821681602
Provider Name (Legal Business Name): BRIANNA RENEE RYCHLEC M.S. CF-SLP/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/12/2021
Last Update Date: 02/12/2021
Certification Date: 02/12/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8044 CHESTERTON DR
WOODRIDGE IL
60517-8010
US
IV. Provider business mailing address
1811 W DIEHL RD STE 100
NAPERVILLE IL
60563-6400
US
V. Phone/Fax
- Phone: 630-687-2743
- Fax:
- Phone: 630-428-1595
- Fax: 630-428-8772
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | 242.005798 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: