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NPI Code Detail

MEDICARE: LAURA M GUENGERICH

MEDICARE:   LAURA M GUENGERICH
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 Pathologist242.000450IL

General Provider Information

NPI Number : 1255476768
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA M GUENGERICH
Provider Business Mailing Address
First Line : 1144 MAPLE AVE
Second Line : 2
City : EVANSTON
State : IL
Zip : 60202-4208
Country : US
Telephone Number : 224-392-6117
Fax Number :
Provider Business Practice Location Address
First Line : 1144 MAPLE AVE
Second Line : 2
City : EVANSTON
State : IL
Zip : 60202-4208
Country : US
Telephone Number : 224-392-6117
Fax Number : 224-392-6117
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2007
Last Update Date : 10/23/2008

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Directions to “ LAURA M GUENGERICH ” Practice Location

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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.