Individual
MS. JAYNE WACHTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP MA
Contact information
Practice address
611 W. PARK, URBANA, IL 61801-2500
(217) 326-2911
(217) 344-8047
Mailing address
611 W. PARK, URBANA, IL 61801-2500
(217) 326-2911
(217) 344-8047
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113326
HEALTHLINK
IL
01
—
203
BLUE CROSS
IL
01
—
4117
HAMP PROVIDER #
IL
01
—
7216
PERSONALCARE
IL
Enumeration date
11/08/2007
Last updated
11/08/2007
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