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NPI Code Detail

MEDICARE: JENNIFER ANN SPEECH THERAPY, INC

MEDICARE: JENNIFER ANN SPEECH THERAPY, INC
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 Pathologist

General Provider Information

NPI Number : 1437798741
Entity Type Code : Organization
Provider Name (Legal Business Name) : JENNIFER ANN SPEECH THERAPY, INC
Provider Business Mailing Address
First Line : 2009 W WALTON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60622-4961
Country : US
Telephone Number : 312-420-1901
Fax Number :
Provider Business Practice Location Address
First Line : 2009 W WALTON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60622-4961
Country : US
Telephone Number : 312-420-1901
Fax Number :
Authorized Official
Title or Position : SPEECH-LANGUAGE PATHOLOGIST
Name : JENNIFER ANN SCHOONOVER
Credential :
Telephone Number : 312-420-1901
Provider Enumeration Date : 01/03/2020
Last Update Date : 01/13/2020

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Directions to “JENNIFER ANN SPEECH THERAPY, INC ” Practice Location

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