MEDICARE: MRS. AKILIA D. T. MCCAIN MA 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	146-006026	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	146-006026	OTHER	IL	STATE LICENSE

General Provider Information

NPI Number	:	1972512150
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AKILIA D. T. MCCAIN MA CCC-SLP

Provider Business Mailing Address
First Line	:	7226 INDIAN BOUNDARY
Second Line	:
City	:	GARY
State	:	IN
Zip	:	46403-1203
Country	:	US
Telephone Number	:	219-939-8655
Fax Number	:	219-939-8994

Provider Business Practice Location Address
First Line	:	10702 S WESTERN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-3136
Country	:	US
Telephone Number	:	773-779-5800
Fax Number	:

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

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	07/08/2007

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Directions to “ MRS. AKILIA D. T. MCCAIN MA CCC-SLP” Practice Location

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