MEDICARE: SCHWANTZ PEDIATRIC THERAPY, INC.

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	146.007756	IL

General Provider Information

NPI Number	:	1194143958
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHWANTZ PEDIATRIC THERAPY, INC.

Provider Business Mailing Address
First Line	:	2208 BAXTER CT
Second Line	:
City	:	ELGIN
State	:	IL
Zip	:	60123-8575
Country	:	US
Telephone Number	:	224-805-6345
Fax Number	:	224-238-7876

Provider Business Practice Location Address
First Line	:	2208 BAXTER CT
Second Line	:
City	:	ELGIN
State	:	IL
Zip	:	60123-8575
Country	:	US
Telephone Number	:	224-805-6345
Fax Number	:	224-238-7876

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. MICHELLE SCHWANTZ
Credential	:	M.A. CCC-SLP
Telephone Number	:	224-805-6345

Provider Enumeration Date	:	03/30/2014
Last Update Date	:	03/30/2014

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Directions to “SCHWANTZ PEDIATRIC THERAPY, INC. ” Practice Location

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