Josette Leanna Peters

Individual provider Active NPI Speech-Language Pathologist · Clifton, IL

NPI 1033891718 · NPPES record last updated Aug 2, 2023

Key facts

NPI
1033891718
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
242.007402 (IL)
Practice address
2882 N 1100 East Rd
Clifton, IL 60927-7101
Phone
(779) 240-0140
NPI assigned
Aug 2, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
242.007402ILMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 242.007402 IL Yes

Addresses

Primary practice location

2882 N 1100 East Rd
Clifton, IL 60927-7101

Mailing address

2882 N 1100 East Rd
Clifton, IL 60927-7101
Phone (779) 240-0140

Other providers in Clifton, IL

All providers in Clifton, IL · Speech-Language Pathologist in Illinois

Sources for this page

Verify at the official NPI Registry.