Individual
JACQUELINE J WEISSMUELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP/L
Contact information
Practice address
14425 KILDARE AVE, MIDLOTHIAN, IL 60445-2649
(708) 309-5459
(708) 597-5422
Mailing address
14425 S. KILDARE AVE, MIDLOTHIAN, IL 60445
(708) 309-5459
(708) 597-5422
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146-009080
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001632676
BLUE CROSS/BLUE SHIELD
IL
Enumeration date
10/02/2007
Last updated
10/02/2007
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