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Organization

WEST SUBURBAN SPEECH PATHOLOGY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. AMY V RUSSELL M.S. (MANAGING DIRECTOR)
(773) 501-1328
Entity
Organization

Contact information

Practice address
2224 MAYFAIR AVE, WESTCHESTER, IL 60154-5061
(773) 501-1328
Mailing address
2224 MAYFAIR AVE, WESTCHESTER, IL 60154-5061
(773) 501-1328

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
146009757
IL

Other

Enumeration date
02/17/2010
Last updated
02/17/2010
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