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NPI Code Detail

MEDICARE: ASHLEY J MCDOWELL SLP

MEDICARE: ASHLEY J MCDOWELL 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 Pathologist242000307IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1710957905OTHERILFEIN
204932271OTHERILBLUE SHIELD

General Provider Information

NPI Number : 1619017373
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY J MCDOWELL SLP
Provider Business Mailing Address
First Line : PO BOX 764
Second Line :
City : LAKE VILLA
State : IL
Zip : 60046-0764
Country : US
Telephone Number : 847-265-7300
Fax Number : 847-265-7301
Provider Business Practice Location Address
First Line : 89 CEDAR AVE
Second Line :
City : LAKE VILLA
State : IL
Zip : 60046-8411
Country : US
Telephone Number : 847-265-7300
Fax Number : 847-265-7301
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2007
Last Update Date : 09/23/2010

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Directions to “ ASHLEY J MCDOWELL SLP” Practice Location

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