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NPI Code Detail

MEDICARE: MRS. CARYN LEIGH GOODMAN M.A. CCC-SLP

MEDICARE: MRS. CARYN LEIGH GOODMAN M.A. CCC-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 PathologistIL

General Provider Information

NPI Number : 1720274772
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CARYN LEIGH GOODMAN M.A. CCC-SLP
Provider Business Mailing Address
First Line : 225 S SANGAMON ST
Second Line : UNIT 706
City : CHICAGO
State : IL
Zip : 60607-3196
Country : US
Telephone Number : 917-570-3427
Fax Number :
Provider Business Practice Location Address
First Line : 225 S SANGAMON ST
Second Line : UNIT 706
City : CHICAGO
State : IL
Zip : 60607-3196
Country : US
Telephone Number : 917-570-3427
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2007
Last Update Date : 09/23/2007

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Directions to “ MRS. CARYN LEIGH GOODMAN M.A. CCC-SLP” Practice Location

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