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General NPI Number Information
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NPI Number | 1609193515
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Entity Type | Organization
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Legal Business Name | MEMORYCARE CORPORATION
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Dates
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Enumeration Date | 05/01/2010
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Last Update Date | 12/04/2022
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Provider Practice Location Address
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Address Line | 1057 CHADWICK CT
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City | AURORA
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State | IL
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Zip | 60502-9323
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Country | US
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Telephone | 630-800-2444
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Fax | 773-904-2361
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Provider Business Mailing Address
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Address Line | 1057 CHADWICK CT
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City | AURORA
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State | IL
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Zip | 60502-9323
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Country | US
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Telephone | 630-800-2444
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Fax | 773-904-2361
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Authorized Official
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Title or Position | PRESIDENT
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Name | REBECCA M KHAYUM
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Credential | M.S., CCC-SLP
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Telephone | 773-904-8447
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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 | 146.008945
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License Number State | IL
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