| NPI | 1710473160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE MARIE ERICKSON-KELLER Speech Language Pathologist 815-671-2885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0700X Clinic/Center Hearing and Speech (Licence: IL 146011665) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: IL 146011665) |
| 261QA3000X Clinic/Center Augmentative Communication | |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2023-04-10 |