MEDICARE: MS. JANET M. FARR MA, CCC-SLP/L

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		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1633448	OTHER	IL	BCBS ID NUMBER

General Provider Information

NPI Number	:	1306802897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANET M. FARR MA, CCC-SLP/L

Provider Business Mailing Address
First Line	:	2126 N SEDGWICK ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-4620
Country	:	US
Telephone Number	:	773-665-4246
Fax Number	:	773-665-4246

Provider Business Practice Location Address
First Line	:	2126 N SEDGWICK ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-4620
Country	:	US
Telephone Number	:	773-665-4246
Fax Number	:	773-665-4246

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

Provider Enumeration Date	:	04/24/2006
Last Update Date	:	07/08/2007

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Directions to “ MS. JANET M. FARR MA, CCC-SLP/L” Practice Location

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