Organization
NORTHWESTERN ILLINOIS ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANE NEISENDORF (COORDINATOR)
(815) 895-9227
Entity
Organization
Contact information
Practice address
1895 BUNKER HILL RD, DUBUQUE, IA 52001-3004
(563) 582-4387
Mailing address
245 W EXCHANGE ST, SYCAMORE, IL 60178-1495
Taxonomy
Speciality
Code
Description
License number
State
235500000X
Speech/Language/Hearing Specialist/Technologist
Primary
2252428
IL
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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