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General NPI Number Information
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NPI Number | 1447561881
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Entity Type | Organization
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Legal Business Name | CHMELA FLUENCY CENTER, INC.
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Dates
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Enumeration Date | 06/30/2010
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Last Update Date | 06/30/2010
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Provider Practice Location Address
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Address Line | 146 OLD MCHENRY RD UNIT 1R
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City | LONG GROVE
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State | IL
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Zip | 60047-8858
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Country | US
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Telephone | 847-293-2571
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Fax |
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Provider Business Mailing Address
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Address Line | 146 OLD MCHENRY RD UNIT 1R
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City | LONG GROVE
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State | IL
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Zip | 60047-8858
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Country | US
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Telephone | 847-293-2571
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MRS. KRISTIN A. CHMELA
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Credential | M.A. CCC-SLP
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Telephone | 847-293-2571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 146003373
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License Number State | IL
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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 | 146003373
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License Number State | IL
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