MEDICARE: PROTALK

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	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1780255901
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROTALK

Provider Business Mailing Address
First Line	:	2915 W COYLE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-2923
Country	:	US
Telephone Number	:	347-752-3233
Fax Number	:

Provider Business Practice Location Address
First Line	:	2915 W COYLE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-2923
Country	:	US
Telephone Number	:	347-752-3233
Fax Number	:

Authorized Official
Title or Position	:	SPEECH LANGUAGE THERAPIST
Name	:	MRS. BONNIE BAILA SARA FRIEDMAN
Credential	:	MA
Telephone Number	:	347-752-3233

Provider Enumeration Date	:	07/08/2021
Last Update Date	:	07/08/2021

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Directions to “PROTALK ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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