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NPI Code Detail

MEDICARE: MS. BETHANY A RIEBOCK MA, CF-SLP

MEDICARE: MS. BETHANY A RIEBOCK MA, CF-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
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1548494438
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BETHANY A RIEBOCK MA, CF-SLP
Provider Business Mailing Address
First Line : 395 JEFFERSON AVE
Second Line :
City : ELGIN
State : IL
Zip : 60120-3847
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4920 N KENMORE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60640-3710
Country : US
Telephone Number : 773-769-2700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2009
Last Update Date : 05/07/2009

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Directions to “ MS. BETHANY A RIEBOCK MA, CF-SLP” Practice Location

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