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General NPI Number Information
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NPI Number | 1376260125
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Entity Type | Organization
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Legal Business Name | SPEAKEASY SPEECH AND LANGUAGE SERVICES INC
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Dates
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Enumeration Date | 10/24/2022
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Last Update Date | 04/28/2023
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Provider Practice Location Address
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Address Line | 1757 N KIMBALL AVE # 205A
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City | CHICAGO
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State | IL
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Zip | 60647-4805
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Country | US
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Telephone | 630-417-2334
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Fax |
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Provider Business Mailing Address
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Address Line | 2243 W THOMAS ST # 1
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City | CHICAGO
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State | IL
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Zip | 60622-3515
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Country | US
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Telephone | 630-417-2334
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHRISTINE DRISCOLL
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Credential |
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Telephone | 630-417-2334
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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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