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General NPI Number Information
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NPI Number | 1356901151
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Entity Type | Individual
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Provider Name | DINA MANALAC CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 06/14/2019
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 5425 W 31ST ST
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City | CICERO
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State | IL
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Zip | 60804-3989
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Country | US
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Telephone | 615-440-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 675 LAKE ST APT 230
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City | OAK PARK
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State | IL
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Zip | 60301-1409
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Country | US
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Telephone | 615-440-1500
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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 | 146.017807
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License Number State | IL
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