Provider Demographics
NPI:1073080677
Name:GEILER, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:GEILER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 WARRIOR WAY
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:61548-9108
Mailing Address - Country:US
Mailing Address - Phone:309-383-2121
Mailing Address - Fax:
Practice Address - Street 1:103 WARRIOR WAY
Practice Address - Street 2:
Practice Address - City:GERMANTOWN HILLS
Practice Address - State:IL
Practice Address - Zip Code:61548-9108
Practice Address - Country:US
Practice Address - Phone:309-383-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL140606340235Z00000X
IL146006340235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist