MEDICARE: KATHLEEN ANN BECK M.A. 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	146007843	IL

General Provider Information

NPI Number	:	1467696252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN ANN BECK M.A. CCC-SLP

Provider Business Mailing Address
First Line	:	345 E SUPERIOR ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-2654
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6504 N BOSWORTH AVE # 3
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60626-4911
Country	:	US
Telephone Number	:	773-727-8816
Fax Number	:

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

Provider Enumeration Date	:	04/24/2009
Last Update Date	:	04/24/2009

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Directions to “ KATHLEEN ANN BECK M.A. CCC-SLP” Practice Location

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