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General NPI Number Information
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NPI Number | 1194143958
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Entity Type | Organization
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Legal Business Name | SCHWANTZ PEDIATRIC THERAPY, INC.
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Dates
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Enumeration Date | 03/30/2014
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Last Update Date | 03/30/2014
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Provider Practice Location Address
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Address Line | 2208 BAXTER CT
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City | ELGIN
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State | IL
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Zip | 60123-8575
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Country | US
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Telephone | 224-805-6345
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Fax | 224-238-7876
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Provider Business Mailing Address
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Address Line | 2208 BAXTER CT
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City | ELGIN
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State | IL
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Zip | 60123-8575
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Country | US
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Telephone | 224-805-6345
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Fax | 224-238-7876
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MICHELLE SCHWANTZ
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Credential | M.A. CCC-SLP
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Telephone | 224-805-6345
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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 | 146.007756
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License Number State | IL
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