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Organization
NORTHSHORE SPEECH THERAPY LLC
Active
Organization
NORTHSHORE SPEECH THERAPY LLC
Active
Parent organization
NORTHSHORE SPEECH THERAPY LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHSHORE SPEECH THERAPY LLC
Authorized official
LAUREN DEANNE TASIOPOULOS BS, MS CCC-SLP/L (SPEECH-LANGUAGE PATHOLOGIST)
(847) 946-7609
Entity
Organization
Contact information
Practice address
1880 W WINCHESTER RD STE 201, LIBERTYVILLE, IL 60048-5336
(312) 970-0208
Mailing address
1100 ANDERSON DR, LIBERTYVILLE, IL 60048-4508
(847) 946-7609
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15715976
CAQH
IL
Enumeration date
10/06/2022
Last updated
10/06/2022
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