Provider Demographics
NPI:1043591977
Name:LITWILLER, AMY ELAINE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ELAINE
Last Name:LITWILLER
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 1:4600 FRONTAGE RD
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60162-1761
Mailing Address - Country:US
Mailing Address - Phone:708-544-9933
Mailing Address - Fax:
Practice Address - Street 1:4600 FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:HILLSIDE
Practice Address - State:IL
Practice Address - Zip Code:60162-1761
Practice Address - Country:US
Practice Address - Phone:708-544-9933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.008608235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist