Individual
JUDITH M GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA,CCC-SLP/L,C/NDT
Contact information
Practice address
830 S ADDISON AVE, VILLA PARK, IL 60181-2877
(630) 620-4433
(630) 620-1148
Mailing address
830 S ADDISON AVE, VILLA PARK, IL 60181-2877
(630) 620-4433
(630) 620-1148
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146-000245
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146000245
SLP LICENSE
IL
Enumeration date
08/25/2006
Last updated
03/12/2019
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