| NPI | 1972200541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNSEY JACOBS Speech Language Pathologist 815-404-7646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0700X Clinic/Center, Hearing and Speech |
| Enumeration Date | 2023-02-14 |
| Last Update Date | 2023-02-14 |