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General NPI Number Information
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NPI Number | 1740474923
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Entity Type | Individual
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Provider Name | MICHAEL JOHN NEARY JR. M.S., CCC-SLP
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Gender | Male
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Dates
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Enumeration Date | 08/30/2007
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Last Update Date | 08/30/2007
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Provider Practice Location Address
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Address Line | 1301 W MADISON ST #512
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City | CHICAGO
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State | IL
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Zip | 60607-1936
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Country | US
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Telephone | 312-850-3128
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 W MADISON ST #512
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City | CHICAGO
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State | IL
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Zip | 60607-1936
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Country | US
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Telephone | 312-850-3128
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | IL
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