Provider Demographics
NPI:1033495486
Name:WYSS, JULIE M (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:WYSS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 REGENT DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-3205
Mailing Address - Country:US
Mailing Address - Phone:402-617-2621
Mailing Address - Fax:
Practice Address - Street 1:1200 W CENTRAL RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2403
Practice Address - Country:US
Practice Address - Phone:847-506-3482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-31
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1297235Z00000X
IL146011449235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist