MEDICARE: MRS. MICHELE ROSE NORRIS 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
1	235Z00000X	Speech-Language Pathologist	146.008322	IL

General Provider Information

NPI Number	:	1912180159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICHELE ROSE NORRIS M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	687 NORTHWIND LN
Second Line	:
City	:	LAKE VILLA
State	:	IL
Zip	:	60046-6665
Country	:	US
Telephone Number	:	815-403-3870
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 SUNSET DR
Second Line	:
City	:	ROUND LAKE
State	:	IL
Zip	:	60073-2827
Country	:	US
Telephone Number	:	224-842-2455
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2007
Last Update Date	:	04/15/2025

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