=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366308215
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WILLOW ROOTS SPEECH & LANGUAGE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/05/2026
-----------------------------------------------------
Last Update Date | 01/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7622 CHURCH ST
-----------------------------------------------------
City | MORTON GROVE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60053-1617
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-422-6089
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7622 CHURCH ST
-----------------------------------------------------
City | MORTON GROVE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60053-1617
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-422-6089
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SPEECH-LANGUAGE PATHOLOGIST / OWNER
-----------------------------------------------------
Name | NATASHA V. GIGLIOTTI
-----------------------------------------------------
Credential | MA CCC-SLP BCS-SCF
-----------------------------------------------------
Telephone | 818-422-6089
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------