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Organization
PLAINFIELD COMMUNITY CONSOLIDATED SCHOOL DISTRICT 202
Active
Organization
PLAINFIELD COMMUNITY CONSOLIDATED SCHOOL DISTRICT 202
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY WHALEN (SPEECH LANGUAGE PATHOLOGIST)
(630) 854-6137
Entity
Organization
Contact information
Practice address
2501 MIRAGE AVE, PLAINFIELD, IL 60586-2145
(815) 439-4828
Mailing address
12706 WEXFORD DR, PLAINFIELD, IL 60585-2885
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
366005688
—
IL
Enumeration date
02/20/2019
Last updated
02/20/2019
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