Amanda Patten

Individual provider Active NPI Speech-Language Pathologist · Coal City, IL

NPI 1144745100 · NPPES record last updated Aug 10, 2017

Key facts

NPI
1144745100
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
Practice address
300 N Broadway St
Coal City, IL 60416-1043
Phone
(815) 634-2334
Fax
(815) 954-6904
NPI assigned
Aug 10, 2017
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

Specialties & licenses

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

Addresses

Primary practice location

300 N Broadway St
Coal City, IL 60416-1043

Mailing address

990 N 7TH St
Carbon Hill, IL 60416-7008
Phone (815) 954-6904

Other providers in Coal City, IL

All providers in Coal City, IL · Speech-Language Pathologist in Illinois

Sources for this page

Verify at the official NPI Registry.