| NPI | 1497923767 |
|---|---|
| Doing Business As | SPEECH-LANGUAGE PATHOLOGY CLINIC |
| Entity Type | Organization |
| Authorized Contact | CLARION MENDES Director Of Clinical Education 217-333-2205 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: IL 146003459) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist (Licence: IL 146008043) |
| 235Z00000X Speech-Language Pathologist (Licence: IL 146004209) | |
| 235Z00000X Speech-Language Pathologist (Licence: IL 146000794) | |
| 235Z00000X Speech-Language Pathologist (Licence: IL 146005525) | |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2019-08-27 |