Organization
GENESIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA DOROTHEA MUELLER (SPEECH-LANGUAGE PATHOLOGIST)
(616) 520-3959
Entity
Organization
Contact information
Practice address
3400 S INDIANA AVE, CHICAGO, IL 60616-3841
(312) 842-5000
Mailing address
1512 W SCHOOL ST, APT 2, CHICAGO, IL 60657-9536
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
146010384
IL
Other
Enumeration date
12/01/2011
Last updated
12/01/2011
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