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General NPI Number Information
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NPI Number | 1023996659
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Entity Type | Individual
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Provider Name | JOY JULIE ANNE BUETA MHS CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/22/2025
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 5110 W 24TH ST
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City | CICERO
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State | IL
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Zip | 60804-2948
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Country | US
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Telephone | 708-863-4856
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Fax |
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Provider Business Mailing Address
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Address Line | 10837 S KOMENSKY AVE
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City | OAK LAWN
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State | IL
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Zip | 60453-5369
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Country | US
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Telephone | 909-434-4156
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 146016359
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License Number State | IL
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