Andrea Rocha

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

NPI 1104594084 · NPPES record last updated Aug 22, 2024

Key facts

NPI
1104594084
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
242.006487 (IL)
Practice address
6021 S 74TH Ave
Summit, IL 60501-1500
Phone
(708) 458-7260
NPI assigned
Sep 3, 2021
Sex
Female
Sole proprietor
No

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
242.006487ILMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 242.006487 IL Yes

Addresses

Primary practice location

6021 S 74TH Ave
Summit, IL 60501-1500

Mailing address

9739 S Utica Ave
Evergreen Park, IL 60805-3150

Other practice location 1

9739 S Utica Ave
Evergreen Park, IL 60805-3150
Phone (773) 512-9225

Other providers in Summit, IL

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

Sources for this page

Verify at the official NPI Registry.