MEDICARE: CHATTERBUG SPEECH & LANGUAGE CENTER

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		IL

General Provider Information

NPI Number	:	1114018751
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHATTERBUG SPEECH & LANGUAGE CENTER

Provider Business Mailing Address
First Line	:	3404 N BELL AVE
Second Line	:	#1
City	:	CHICAGO
State	:	IL
Zip	:	60618-6002
Country	:	US
Telephone Number	:	773-316-5708
Fax Number	:

Provider Business Practice Location Address
First Line	:	3404 N BELL AVE
Second Line	:	#1
City	:	CHICAGO
State	:	IL
Zip	:	60618-6002
Country	:	US
Telephone Number	:	773-316-5708
Fax Number	:

Authorized Official
Title or Position	:	TREASURER
Name	:	MS. MOLLY ANN GUMMERSON
Credential	:	MS,CCC-SLP
Telephone Number	:	773-316-5708

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	08/22/2020

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Directions to “CHATTERBUG SPEECH & LANGUAGE CENTER ” Practice Location

Language	Start Address	Practice Location

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