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Organization

AG SLP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALYSSA BOSWORTH MS CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
(312) 208-4556
Entity
Organization

Contact information

Practice address
412 MEADOWLARK RD, BLOOMINGDALE, IL 60108-1332
(312) 208-4556
Mailing address
123 S LODGE LN, LOMBARD, IL 60148-2918
(312) 208-4556

Taxonomy

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

Other

Enumeration date
12/05/2023
Last updated
12/05/2023
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