Amy Ruth Burke
Individual provider Active NPI Speech-Language Pathologist · Macomb, IL
NPI 1699098764 · NPPES record last updated Mar 3, 2010
Key facts
- NPI
- 1699098764
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 146003793 (IL)
- Practice address
- 525 E Grant St
Macomb, IL 61455-3313 - Phone
- (309) 833-4101
- Fax
- (309) 836-1589
- NPI assigned
- Mar 3, 2010
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 146003793 | IL | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146003793 | IL | Yes |
Addresses
Primary practice location
525 E Grant St
Macomb, IL 61455-3313
Mailing address
12911 E 900TH St
Macomb, IL 61455-8907
Phone (309) 833-4101
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- Michael Clayton Burgard
- Brandon James Burnett
- Trudy Maria Buster
- Susanne Carol Campbell
- Edwin L Card
- Gerald L Carreon
All providers in Macomb, 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 Mar 3, 2010. 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.