Julie Draper
Individual provider Active NPI Speech-Language Pathologist · Alto Pass, IL
NPI 1669595146 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1669595146
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- Practice address
- 610 Lake Dr
Alto Pass, IL 62905-1015 - Phone
- (618) 893-4493
- NPI assigned
- Apr 9, 2007
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 146001749 | IL | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | IL | Yes |
Addresses
Primary practice location
610 Lake Dr
Alto Pass, IL 62905-1015
Mailing address
610 Lake Dr
Alto Pass, IL 62905-1015
Phone (618) 893-4493
Other providers in Alto Pass, IL
All providers in Alto Pass, IL · Speech-Language Pathologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.