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Organization
WANNEMACHER THERAPY SERVICES, P.C.
Active
Organization
WANNEMACHER THERAPY SERVICES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS TRACY WANNEMACHER M.S. CCC-SLP/L (SPEECH PATHOLOGIST)
(815) 260-6596
Entity
Organization
Contact information
Practice address
1254 PULLMAN RD, APT. 304, ROMEOVILLE, IL 60446-4183
(815) 260-6596
(206) 462-1510
Mailing address
1254 PULLMAN RD, APT. 304, ROMEOVILLE, IL 60446-4183
(815) 260-6596
(206) 462-1510
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.005457
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
320761490001
—
IL
Enumeration date
01/15/2009
Last updated
01/15/2009
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