| NPI | 1740427400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY WANNEMACHER Speech Pathologist 815-260-6596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 146.005457) |
| Enumeration Date | 2009-01-15 |
| Last Update Date | 2009-01-15 |