Individual
JULIA DUNGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC, SLP
Contact information
Practice address
1456 KINGSLEY DR, SHILOH, IL 62269-7253
(217) 370-5624
(888) 627-4177
Mailing address
1456 KINGSLEY DR, SHILOH, IL 62269-7253
(217) 370-5624
(888) 627-4177
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.011319
IL
235Z00000X
Speech-Language Pathologist
2560
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51538180
BCBS
AL
01
—
582492069
TRICARE
AL
05
—
890018910
—
AL
Enumeration date
02/12/2007
Last updated
09/19/2014
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