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General NPI Number Information
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NPI Number | 1992137285
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Entity Type | Organization
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Legal Business Name | CHICAGO SPEECH SPOT
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Dates
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Enumeration Date | 08/08/2013
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Last Update Date | 08/08/2013
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Provider Practice Location Address
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Address Line | 770 N HALSTED ST SUITE 6S
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City | CHICAGO
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State | IL
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Zip | 60642-5999
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Country | US
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Telephone | 312-600-7231
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Fax |
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Provider Business Mailing Address
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Address Line | 770 N HALSTED ST SUITE 6S
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City | CHICAGO
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State | IL
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Zip | 60642-5999
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Country | US
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Telephone | 312-600-7231
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | TANYA LOTZOF
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Credential | M.A. CCC-SLP
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Telephone | 847-209-5353
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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 | 146011495
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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 | 146010960
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License Number State | IL
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