Jennifer Ilconich, MA, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Cecil, PA
NPI 1144623976 · NPPES record last updated Oct 7, 2014
Key facts
- NPI
- 1144623976
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SL008386 (PA)
- Practice address
- 146 Valleycrest Dr
Cecil, PA 15321-1138 - Phone
- (419) 787-8678
- NPI assigned
- Oct 7, 2014
- 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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SL008386 | PA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SL008386 | PA | Yes |
Addresses
Primary practice location
146 Valleycrest Dr
Cecil, PA 15321-1138
Mailing address
146 Valleycrest Dr
Cecil, PA 15321-1138
Phone (419) 787-8678
Other providers in Cecil, PA
- Cecil Chiropractic
- Cecil Chiropractic & Rehabilitation, PC
- David Desafey II
- Sarah Carolyn Duncan
- Donald J Faith
- George E Khoury
- Kathleen Mayree Shadish
- Mylaina Lyn Sherwood
- Steel City Chiropractic, LLC
- The Washington Physician Hospital Organization, Inc.
All providers in Cecil, PA · Speech-Language Pathologist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2014. 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.