Michelle Coughlin

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

NPI 1659945152 · NPPES record last updated May 18, 2021

Key facts

NPI
1659945152
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
146015252 (IL)
Practice address
509 Taylor Dr
Chillicothe, IL 61523-1371
Phone
(309) 634-5420
NPI assigned
May 18, 2021
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)
Yes

State licenses

LicenseStateTypeSpecialty
146015252ILMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist
Group: 193400000X SINGLE SPECIALTY GROUP
235Z00000X 146015252 IL Yes

Addresses

Primary practice location

509 Taylor Dr
Chillicothe, IL 61523-1371

Mailing address

509 Taylor Dr
Chillicothe, IL 61523-1371

Other providers in Chillicothe, IL

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

Sources for this page

Verify at the official NPI Registry.