NPIMap

Edwige Charles

Individual provider Active NPI Speech-Language Pathologist · South Holland, IL

NPI 1194265124 · NPPES record last updated Aug 2, 2021

Key facts

NPI
1194265124
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
146015176 (IL)
Practice address
15206 Naughton Dr
South Holland, IL 60473-1115
Phone
(708) 299-9714
NPI assigned
Feb 23, 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

State licenses

LicenseStateTypeSpecialty
SLP001072DCMDSpeech-Language Pathologist
146015176ILMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP001072 DC
Speech-Language Pathologist 235Z00000X 146015176 IL Yes

Addresses

Primary practice location

15206 Naughton Dr
South Holland, IL 60473-1115

Mailing address

680 Rhode Island Ave NE
Suite I
Washington, DC 20002-1269
Phone (202) 575-5404

Other practice location 1

680 Rhode Island Ave NE
Suite I
Washington, DC 20002-1269
Phone (202) 575-5404

Other practice location 2

15206 Naughton Dr
South Holland, IL 60473-1115
Phone (708) 299-9714

Other providers in South Holland, IL

All providers in South Holland, IL · Speech-Language Pathologist in Illinois

Sources for this page

Verify at the official NPI Registry.