MEDICARE: MRS. AMANDA MARIE ALBRIGHT M.S.

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

General Provider Information

NPI Number	:	1457339608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMANDA MARIE ALBRIGHT M.S.

Provider Business Mailing Address
First Line	:	534 W CORNELIA AVE
Second Line	:	UNIT 3N
City	:	CHICAGO
State	:	IL
Zip	:	60657-2746
Country	:	US
Telephone Number	:	312-848-6315
Fax Number	:	312-275-8499

Provider Business Practice Location Address
First Line	:	534 W CORNELIA AVE
Second Line	:	UNIT 3N
City	:	CHICAGO
State	:	IL
Zip	:	60657-2746
Country	:	US
Telephone Number	:	312-848-6315
Fax Number	:	312-275-8499

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

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	09/06/2007

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Directions to “ MRS. AMANDA MARIE ALBRIGHT M.S.” Practice Location

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