Elizabeth Ann Macy, M.S. CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Ingleside, IL

NPI 1285146993 · NPPES record last updated Nov 3, 2017

Key facts

NPI
1285146993
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
146012359 (IL)
Practice address
33315 N Fish Lake Rd
Ingleside, IL 60041-9263
Phone
(847) 740-1490
NPI assigned
Nov 3, 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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
146012359ILMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 146012359 IL Yes

Addresses

Primary practice location

33315 N Fish Lake Rd
Ingleside, IL 60041-9263

Mailing address

33315 N Fish Lake Rd
Ingleside, IL 60041-9263
Phone (847) 740-1490

Other providers in Ingleside, IL

All providers in Ingleside, IL · Speech-Language Pathologist in Illinois

Sources for this page

Verify at the official NPI Registry.