Deborah L Berg, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Lake Forest, IL

NPI 1124216668 · NPPES record last updated Oct 5, 2009

Key facts

NPI
1124216668
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
146.001993 (IL)
Practice address
660 N Westmoreland Rd
Lake Forest, IL 60045-1659
Phone
(847) 234-6114
NPI assigned
Oct 10, 2007
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
146.001993ILMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 146.001993 IL Yes

Addresses

Primary practice location

660 N Westmoreland Rd
Lake Forest, IL 60045-1659

Mailing address

660 N Westmoreland Rd
Lake Forest, IL 60045-1659
Phone (847) 234-6114

Other providers in Lake Forest, IL

All providers in Lake Forest, IL · Speech-Language Pathologist in Illinois

Sources for this page

Verify at the official NPI Registry.