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General NPI Number Information
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NPI Number | 1902006091
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Entity Type | Individual
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Provider Name | SHERI LYNN ISAACSON
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Gender | Female
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Dates
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Enumeration Date | 07/18/2007
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Last Update Date | 01/02/2020
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Provider Practice Location Address
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Address Line | N1860 SHORE DR
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City | MARINETTE
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State | WI
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Zip | 54143-9212
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Country | US
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Telephone | 715-330-3109
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Fax | 815-521-9295
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Provider Business Mailing Address
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Address Line | 24829 S TRYON ST
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City | CHANNAHON
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State | IL
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Zip | 60410-5294
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Country | US
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Telephone | 815-931-5977
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Fax | 815-521-9295
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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 | 146.006923
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License Number State | IL
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