Provider Demographics
NPI:1063681757
Name:TORRI, BERNARD J (MASTERS DEGREE MA)
Entity Type:Individual
Prefix:MR
First Name:BERNARD
Middle Name:J
Last Name:TORRI
Suffix:
Gender:M
Credentials:MASTERS DEGREE MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2741 COLUMBUS ST
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:IL
Mailing Address - Zip Code:61350-1005
Mailing Address - Country:US
Mailing Address - Phone:815-434-4748
Mailing Address - Fax:815-434-4749
Practice Address - Street 1:2741 COLUMBUS ST
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:IL
Practice Address - Zip Code:61350-1005
Practice Address - Country:US
Practice Address - Phone:815-434-4748
Practice Address - Fax:815-434-4749
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231H00000X
IL147000362231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL$$$$$$$$$001Medicaid