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Organization

CHILDREN'S MEMORIAL HOSPITAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TYLER SHANE JOHNSON M.S., CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
(773) 327-2880
Entity
Organization

Contact information

Practice address
2300 N CHILDRENS PLZ, BOX 142, CHICAGO, IL 60614-3363
(773) 327-2880
(773) 327-0547
Mailing address
2300 N CHILDRENS PLZ, BOX 142, CHICAGO, IL 60614-3363
(773) 327-2880
(773) 327-0547

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
IL

Other

Enumeration date
12/12/2006
Last updated
08/22/2020
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