Beth Ann Fraley, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Wood Dale, IL

NPI 1376720797 · NPPES record last updated Jan 28, 2008

Key facts

NPI
1376720797
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
Practice address
494 W Clare CT
Wood Dale, IL 60191-2723
Phone
(630) 422-7116
NPI assigned
Jan 28, 2008
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

State licenses

LicenseStateTypeSpecialty
146.008515ILMDSpeech-Language Pathologist

Specialties & licenses

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

Addresses

Primary practice location

494 W Clare CT
Wood Dale, IL 60191-2723

Mailing address

494 W Clare CT
Wood Dale, IL 60191-2723
Phone (630) 422-7116

Other providers in Wood Dale, IL

All providers in Wood Dale, IL · Speech-Language Pathologist in Illinois

Sources for this page

Verify at the official NPI Registry.