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NPI Code Detail

MEDICARE: TARA HOLDEN

MEDICARE: TARA HOLDEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist242003416IL

General Provider Information

NPI Number : 1013300250
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA HOLDEN
Provider Business Mailing Address
First Line : 310 S MAIN ST STE D
Second Line :
City : LOMBARD
State : IL
Zip : 60148-2692
Country : US
Telephone Number : 630-652-0200
Fax Number : 630-652-0300
Provider Business Practice Location Address
First Line : 310 S MAIN ST STE D
Second Line :
City : LOMBARD
State : IL
Zip : 60148-2692
Country : US
Telephone Number : 630-652-0200
Fax Number : 630-652-0300
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2015
Last Update Date : 03/12/2015

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Directions to “ TARA HOLDEN ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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