Elizabeth Anne Bennett

Individual provider Active NPI Speech-Language Pathologist · Morton Grove, IL

NPI 1154836815 · NPPES record last updated Dec 4, 2017

Key facts

NPI
1154836815
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
Practice address
8701 Menard Ave
Morton Grove, IL 60053-3052
Phone
(317) 294-0920
NPI assigned
Dec 4, 2017
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

Specialties & licenses

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

Addresses

Primary practice location

8701 Menard Ave
Morton Grove, IL 60053-3052

Mailing address

8701 Menard Ave
Morton Grove, IL 60053-3052
Phone (317) 294-0920

Other providers in Morton Grove, IL

All providers in Morton Grove, IL · Speech-Language Pathologist in Illinois

Sources for this page

Verify at the official NPI Registry.