MEDICARE: ANGELA CHRISTINE BEARD-BEAL MS,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	105685	TX
2	235Z00000X	Speech-Language Pathologist	146010507	IL
3	235Z00000X	Speech-Language Pathologist	SL009889	PA
4	235Z00000X	Speech-Language Pathologist	SLP012485	GA
5	235Z00000X	Speech-Language Pathologist	2202010827	VA

General Provider Information

NPI Number	:	1366750549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA CHRISTINE BEARD-BEAL MS,CCC-SLP

Provider Business Mailing Address
First Line	:	1295 MACKINAW AVE
Second Line	:
City	:	CALUMET CITY
State	:	IL
Zip	:	60409-5730
Country	:	US
Telephone Number	:	708-333-7227
Fax Number	:

Provider Business Practice Location Address
First Line	:	616 FRANCES ST
Second Line	:
City	:	PHOENIX
State	:	IL
Zip	:	60426-2624
Country	:	US
Telephone Number	:	708-333-7227
Fax Number	:

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

Provider Enumeration Date	:	09/21/2010
Last Update Date	:	08/01/2024

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