MEDICARE: JULIE B SHAPIRO

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	146.008970	IL

General Provider Information

NPI Number	:	1083264139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE B SHAPIRO

Provider Business Mailing Address
First Line	:	2727 W GREENLEAF AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-3013
Country	:	US
Telephone Number	:	248-310-3383
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 GREEN BAY RD
Second Line	:
City	:	NORTH CHICAGO
State	:	IL
Zip	:	60064-2838
Country	:	US
Telephone Number	:	248-310-3383
Fax Number	:

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

Provider Enumeration Date	:	09/19/2019
Last Update Date	:	09/19/2019

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Directions to “ JULIE B SHAPIRO ” Practice Location

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