Provider Demographics
NPI:1073711552
Name:CAMERON, JULIE (SLP)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:CAMERON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2233
Mailing Address - Country:US
Mailing Address - Phone:708-524-1050
Mailing Address - Fax:708-524-2469
Practice Address - Street 1:411 CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-2233
Practice Address - Country:US
Practice Address - Phone:708-524-1050
Practice Address - Fax:708-524-2469
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146008395235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist