MEDICARE: NICOLE R BARNO M.S., SLP-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
1	235Z00000X	Speech-Language Pathologist	146010406	IL

General Provider Information

NPI Number	:	1366676793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE R BARNO M.S., SLP-CCC

Provider Business Mailing Address
First Line	:	2042 W AUGUSTA BLVD
Second Line	:	3F
City	:	CHICAGO
State	:	IL
Zip	:	60622-4981
Country	:	US
Telephone Number	:	773-931-8289
Fax Number	:

Provider Business Practice Location Address
First Line	:	2042 W AUGUSTA BLVD
Second Line	:	3F
City	:	CHICAGO
State	:	IL
Zip	:	60622-4981
Country	:	US
Telephone Number	:	773-931-8289
Fax Number	:

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

Provider Enumeration Date	:	05/13/2009
Last Update Date	:	07/18/2011

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