| NPI | 1093196370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY LYNN BASEL Speech/Language Pathologist 815-353-9527 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 146.004443) |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2015-06-12 |