Individual
MRS. HEATHER P MATTILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
913 STONEBRIDGE WAY, WOODRIDGE, IL 60517-4919
(630) 783-8458
Mailing address
913 STONEBRIDGE WAY, WOODRIDGE, IL 60517-4919
(630) 783-8458
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2227880
BCBS OF IL
IL
Enumeration date
03/07/2007
Last updated
07/08/2007
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