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General NPI Number Information
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NPI Number | 1255001186
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Entity Type | Individual
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Provider Name | MEGAN MATHIASEN SLP
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Gender | Female
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Dates
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Enumeration Date | 09/13/2021
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 4020 E NEW YORK ST
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City | AURORA
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State | IL
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Zip | 60504-4416
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Country | US
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Telephone | 331-301-5590
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Fax |
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Provider Business Mailing Address
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Address Line | 172 E SAINT CHARLES RD
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City | ELMHURST
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State | IL
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Zip | 60126-3554
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Country | US
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Telephone | 815-501-3779
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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 |
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License Number State |
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