Provider Demographics
NPI:1073829248
Name:TOMALIS, MARIE LAURA (MS CCC-SLP/L)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:LAURA
Last Name:TOMALIS
Suffix:
Gender:F
Credentials:MS CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 W 56TH PL
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-2305
Mailing Address - Country:US
Mailing Address - Phone:773-255-1626
Mailing Address - Fax:
Practice Address - Street 1:7540 S 86TH AVE
Practice Address - Street 2:
Practice Address - City:JUSTICE
Practice Address - State:IL
Practice Address - Zip Code:60458-1168
Practice Address - Country:US
Practice Address - Phone:708-496-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-26
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.010607235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist