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NPI Code Detail

MEDICARE: JEANNINE PHILLIPS M.A. CCC-SLP

MEDICARE: JEANNINE PHILLIPS M.A. 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
1235Z00000XSpeech-Language Pathologist146007050IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11634254OTHERILINSURANCE PROVIDER NUMBER

General Provider Information

NPI Number : 1154466035
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANNINE PHILLIPS M.A. CCC-SLP
Provider Business Mailing Address
First Line : 411 E GENEVA RD
Second Line :
City : CAROL STREAM
State : IL
Zip : 60188-2457
Country : US
Telephone Number : 815-469-1500
Fax Number :
Provider Business Practice Location Address
First Line : 411 E GENEVA RD
Second Line :
City : CAROL STREAM
State : IL
Zip : 60188-2457
Country : US
Telephone Number : 815-469-1500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2007
Last Update Date : 06/11/2024

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Directions to “ JEANNINE PHILLIPS M.A. CCC-SLP” Practice Location

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