MEDICARE: JJS SPEECH & LANGUAGE LAB

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	261QH0700X	Hearing and Speech Clinic/Center

General Provider Information

NPI Number	:	1609709468
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JJS SPEECH & LANGUAGE LAB

Provider Business Mailing Address
First Line	:	1432 N MAPLEWOOD AVE APT 304
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-1878
Country	:	US
Telephone Number	:	708-927-9878
Fax Number	:

Provider Business Practice Location Address
First Line	:	1432 N MAPLEWOOD AVE APT 304
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-1878
Country	:	US
Telephone Number	:	708-927-9878
Fax Number	:

Authorized Official
Title or Position	:	SPEECH LANGUAGE PATHOLOGIST
Name	:	JENNA JABLONSKI
Credential	:
Telephone Number	:	708-927-9878

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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