Individual
EILEEN PETON-THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
106 LINCOLN PLACE CT, BELLEVILLE, IL 62221-5884
(618) 236-7588
Mailing address
106 LINCOLN PLACE CT, BELLEVILLE, IL 62221-5884
(618) 236-7588
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001415008
BCBS OF IL
IL
01
—
5330619
AETNA
—
Enumeration date
01/06/2007
Last updated
07/08/2007
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