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NPI Code Detail

MEDICARE: MRS. LAURA ANN MAXWELL

MEDICARE: MRS. LAURA ANN MAXWELL
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 Pathologist146.012215IL

General Provider Information

NPI Number : 1124434048
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAURA ANN MAXWELL
Provider Business Mailing Address
First Line : 11219 S SAWYER AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60655-2706
Country : US
Telephone Number : 773-253-9856
Fax Number : 773-253-9876
Provider Business Practice Location Address
First Line : 11053 S MILLARD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60655-3327
Country : US
Telephone Number : 773-253-9856
Fax Number : 773-253-9876
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2014
Last Update Date : 05/15/2017

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Directions to “ MRS. LAURA ANN MAXWELL ” 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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