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NPI Code Detail

MEDICARE: MALLORY COPELAND

MEDICARE: MALLORY COPELAND
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 Pathologist146016940IL

General Provider Information

NPI Number : 1952177818
Entity Type Code : Individual
Provider Name (Legal Business Name) : MALLORY COPELAND
Provider Business Mailing Address
First Line : 1750 N WOLCOTT AVE APT 102
Second Line :
City : CHICAGO
State : IL
Zip : 60622-1358
Country : US
Telephone Number : 847-951-1571
Fax Number :
Provider Business Practice Location Address
First Line : 8 S MICHIGAN AVE STE 2100
Second Line :
City : CHICAGO
State : IL
Zip : 60603-3337
Country : US
Telephone Number : 312-392-1640
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2023
Last Update Date : 11/30/2023

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Directions to “ MALLORY COPELAND ” 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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