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NPI Code Detail

MEDICARE: KERRY DANAHY EBERT PHD, CCC

MEDICARE: KERRY DANAHY EBERT PHD, CCC
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 Pathologist7709MN
2235Z00000XSpeech-Language Pathologist146.010908IL

General Provider Information

NPI Number : 1265657928
Entity Type Code : Individual
Provider Name (Legal Business Name) : KERRY DANAHY EBERT PHD, CCC
Provider Business Mailing Address
First Line : 600 S PAULINA ST
Second Line : SUITE 1012
City : CHICAGO
State : IL
Zip : 60612-3806
Country : US
Telephone Number : 312-563-6034
Fax Number :
Provider Business Practice Location Address
First Line : 600 S PAULINA ST
Second Line : SUITE 1012
City : CHICAGO
State : IL
Zip : 60612-3806
Country : US
Telephone Number : 312-563-6034
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2007
Last Update Date : 11/08/2011

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Directions to “ KERRY DANAHY EBERT PHD, CCC” Practice Location

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