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General NPI Number Information
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NPI Number | 1427702547
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Entity Type | Organization
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Legal Business Name | NRG SPEECH AND FEEDING INC.
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Dates
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Enumeration Date | 02/08/2022
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Last Update Date | 09/14/2023
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Provider Practice Location Address
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Address Line | 16325 HARLEM AVE STE 260
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City | TINLEY PARK
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State | IL
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Zip | 60477-1688
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Country | US
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Telephone | 708-638-8147
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Fax |
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Provider Business Mailing Address
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Address Line | 10545 LOREL AVE
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City | OAK LAWN
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State | IL
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Zip | 60453-5154
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Country | US
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Telephone | 708-638-8147
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KATHRYN VILLASENOR
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Credential |
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Telephone | 708-638-8147
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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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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