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NPI Code Detail

MEDICARE: WHITNEY PANDO MHS

MEDICARE:   WHITNEY  PANDO  MHS
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 Pathologist146010470IL

General Provider Information

NPI Number : 1497986087
Entity Type Code : Individual
Provider Name (Legal Business Name) : WHITNEY PANDO MHS
Provider Business Mailing Address
First Line : 1754 LOUISVILLE LN
Second Line :
City : CRYSTAL LAKE
State : IL
Zip : 60014-2921
Country : US
Telephone Number : 815-861-6267
Fax Number : 815-893-0810
Provider Business Practice Location Address
First Line : 1754 LOUISVILLE LN
Second Line :
City : CRYSTAL LAKE
State : IL
Zip : 60014-2921
Country : US
Telephone Number : 815-861-6267
Fax Number : 815-893-0810
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2009
Last Update Date : 09/29/2024

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Directions to “ WHITNEY PANDO MHS” Practice Location

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