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General NPI Number Information
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NPI Number | 1003067265
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Entity Type | Organization
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Legal Business Name | PREMIER SPEECH THERAPY, LTD
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Dates
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Enumeration Date | 10/07/2008
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Last Update Date | 10/07/2008
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Provider Practice Location Address
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Address Line | 3711 N RICHMOND ST
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City | CHICAGO
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State | IL
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Zip | 60618-3524
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Country | US
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Telephone | 312-339-7673
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Fax | 484-210-2342
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Provider Business Mailing Address
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Address Line | 3711 N RICHMOND ST
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City | CHICAGO
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State | IL
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Zip | 60618-3524
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Country | US
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Telephone | 312-339-7673
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Fax | 484-210-2342
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Authorized Official
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Title or Position | PRESIDENT
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Name | ERIN HEDLIN
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Credential | MS CCC-SLP
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Telephone | 312-339-7673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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