Sandra Mae Demaret, SLP
Individual provider Active NPI Speech-Language Pathologist · Fairfield, IL
NPI 1104941731 · NPPES record last updated Sep 29, 2024
Key facts
- NPI
- 1104941731
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 146006583 (IL)
- Practice address
- 1947 County Road 1070 N
Fairfield, IL 62837-2883 - Phone
- (618) 919-0084
- NPI assigned
- Mar 20, 2007
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 146006583 | IL | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146006583 | IL | Yes |
Addresses
Primary practice location
1947 County Road 1070 N
Fairfield, IL 62837-2883
Mailing address
1947 County Road 1070 N
Fairfield, IL 62837-2883
Phone (618) 919-0084
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9632002 | Other | IL | BLUE SHIELD PROVIDER NUMB |
Other providers in Fairfield, IL
- Brandi Leigh Courtright
- Marylouise Mae Curtis
- Walter Lee Dawkins
- Deaconess Specialty Physicians, Inc
- Deaconess Specialty Physicians, Inc
- Developmental Planning & Services Inc
- Developmental Planning & Servoces, Inc.
- DHS
- Edgar G. Dickey
- Edlucy Inc
All providers in Fairfield, IL · Speech-Language Pathologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.