Scott Maguire

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

NPI 1891201265 · NPPES record last updated Dec 21, 2017

Key facts

NPI
1891201265
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
Practice address
11000 S Oketo Ave
Worth, IL 60482-1009
Phone
(708) 671-5865
NPI assigned
Dec 21, 2017
Sex
Male
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

Specialties & licenses

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

Addresses

Primary practice location

11000 S Oketo Ave
Worth, IL 60482-1009

Mailing address

11000 S Oketo Ave
Worth, IL 60482-1009

Other identifiers

IdentifierTypeStateIssuer
235Z00000XMedicaidIL

Other providers in Worth, IL

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

Sources for this page

Verify at the official NPI Registry.