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NPI Code Detail

MEDICARE: MRS. LAURENE M. MCHATTON CCC/SLP-L

MEDICARE: MRS. LAURENE M. MCHATTON CCC/SLP-L
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 Pathologist146.001536IL

General Provider Information

NPI Number : 1639334980
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAURENE M. MCHATTON CCC/SLP-L
Provider Business Mailing Address
First Line : 12 E QUINCY ST
Second Line :
City : RIVERSIDE
State : IL
Zip : 60546-2176
Country : US
Telephone Number : 708-494-0751
Fax Number :
Provider Business Practice Location Address
First Line : 12 E QUINCY ST
Second Line :
City : RIVERSIDE
State : IL
Zip : 60546-2176
Country : US
Telephone Number : 708-494-0751
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2008
Last Update Date : 07/24/2014

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Directions to “ MRS. LAURENE M. MCHATTON CCC/SLP-L” Practice Location

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