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General NPI Number Information
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NPI Number | 1720227234
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Entity Type | Organization
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Legal Business Name | LINDA CERVENKA & ASSOCIATES, P.C.
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Dates
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Enumeration Date | 02/08/2009
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Last Update Date | 02/08/2009
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Provider Practice Location Address
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Address Line | 2225 ENTERPRISE DR SUITE 2505
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City | WESTCHESTER
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State | IL
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Zip | 60154-5814
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Country | US
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Telephone | 708-473-2576
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Fax |
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Provider Business Mailing Address
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Address Line | 2225 ENTERPRISE DR SUITE 2505
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City | WESTCHESTER
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State | IL
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Zip | 60154-5814
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Country | US
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Telephone | 708-473-2576
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Fax |
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Authorized Official
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Title or Position | SPEECH/LANGUAGE PATHOLGIST
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Name | MRS. LINDA CERVENKA
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Credential | M.A.-CCC
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Telephone | 708-473-2576
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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 | 146002616
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License Number State | IL
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