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General NPI Number Information
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NPI Number | 1063729168
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Entity Type | Individual
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Provider Name | ANNIE GOVEA SPT
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Gender | Female
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Dates
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Enumeration Date | 09/10/2010
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 16086 HARLEM AVE
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City | TINLEY PARK
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State | IL
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Zip | 60477-1612
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Country | US
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Telephone | 708-358-7239
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Fax |
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Provider Business Mailing Address
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Address Line | 9500 BORMET DR STE 304
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City | MOKENA
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State | IL
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Zip | 60448-8399
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Country | US
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Telephone | 815-469-1500
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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 | 146.009346
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License Number State | IL
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