Provider Demographics
NPI:1093220501
Name:BACHAND, PATRICIA SUSAN
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:SUSAN
Last Name:BACHAND
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 1:1213 SHAGBARK RD
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-2412
Mailing Address - Country:US
Mailing Address - Phone:815-735-5813
Mailing Address - Fax:
Practice Address - Street 1:15732 S HOWARD ST
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-2399
Practice Address - Country:US
Practice Address - Phone:815-577-4023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-06
Last Update Date:2017-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146002353235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist