MEDICARE: LAUREN ROSE GLASS 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
1	235Z00000X	Speech-Language Pathologist	146.009010	IL

General Provider Information

NPI Number	:	1235665407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN ROSE GLASS M.A. CCC-SLP

Provider Business Mailing Address
First Line	:	3116 W CULLOM AVE #2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618
Country	:	US
Telephone Number	:	312-208-3694
Fax Number	:

Provider Business Practice Location Address
First Line	:	3116 W CULLOM AVE # 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-1304
Country	:	US
Telephone Number	:	312-208-3694
Fax Number	:

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

Provider Enumeration Date	:	05/10/2017
Last Update Date	:	12/21/2025

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Directions to “ LAUREN ROSE GLASS M.A. CCC-SLP” Practice Location

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