MEDICARE: CATHERINE GILLESPIE

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	2355S0801X	Speech-Language Assistant

General Provider Information

NPI Number	:	1154676583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE GILLESPIE

Provider Business Mailing Address
First Line	:	3300 W IRVING PARK RD UNIT N3
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-3359
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 W IRVING PARK RD UNIT N3
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-3359
Country	:	US
Telephone Number	:	708-752-0365
Fax Number	:

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

Provider Enumeration Date	:	07/23/2012
Last Update Date	:	07/23/2012

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Directions to “ CATHERINE GILLESPIE ” Practice Location

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