Provider Demographics
NPI:1043902695
Name:BOZICKOVIC, MONIKA (SLP-CF)
Entity Type:Individual
Prefix:
First Name:MONIKA
Middle Name:
Last Name:BOZICKOVIC
Suffix:
Gender:F
Credentials:SLP-CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:733 GLEN MOR
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62221-3483
Mailing Address - Country:US
Mailing Address - Phone:309-269-4052
Mailing Address - Fax:
Practice Address - Street 1:121 S BLUFF RD
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62234-1970
Practice Address - Country:US
Practice Address - Phone:618-484-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist