MEDICARE: MRS. ANN MARIE IMHERR M.S. CCC-SLP

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
1	235Z00000X	Speech-Language Pathologist	146.008166	IL
2	235Z00000X	Speech-Language Pathologist	3682	OK

General Provider Information

NPI Number	:	1023185808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANN MARIE IMHERR M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	2736 N HAMPDEN CT APT 105
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-1635
Country	:	US
Telephone Number	:	847-845-7516
Fax Number	:

Provider Business Practice Location Address
First Line	:	2736 N HAMPDEN CT APT 105
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-1635
Country	:	US
Telephone Number	:	847-845-7516
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	06/12/2013

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Directions to “ MRS. ANN MARIE IMHERR M.S. CCC-SLP” Practice Location

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