Individual
MRS. JENNIFER FEDELL LAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-A
Contact information
Practice address
2422 W. MAIN ST., ST. CHARLES, IL 60175
(630) 513-5012
Mailing address
16248 S. FARMINGDALE DR., PLAINFIELD, IL 60586
(815) 609-5457
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
—
IL
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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