MEDICARE: SANDRA LYNN CARRINGTON M.S.

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	146007310	IL

General Provider Information

NPI Number	:	1982867479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA LYNN CARRINGTON M.S.

Provider Business Mailing Address
First Line	:	220 N PINE ST
Second Line	:
City	:	DELAVAN
State	:	IL
Zip	:	61734-9287
Country	:	US
Telephone Number	:	309-244-8499
Fax Number	:

Provider Business Practice Location Address
First Line	:	220 N PINE ST
Second Line	:
City	:	DELAVAN
State	:	IL
Zip	:	61734-9287
Country	:	US
Telephone Number	:	309-244-8499
Fax Number	:

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

Provider Enumeration Date	:	07/06/2008
Last Update Date	:	07/06/2008

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Directions to “ SANDRA LYNN CARRINGTON M.S.” Practice Location

Language	Start Address	Practice Location

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