Provider Demographics
NPI:1114018751
Name:CHATTERBUG SPEECH & LANGUAGE CENTER
Entity Type:Organization
Organization Name:CHATTERBUG SPEECH & LANGUAGE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MS
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GUMMERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS,CCC-SLP
Authorized Official - Phone:773-316-5708
Mailing Address - Street 1:3404 N BELL AVE
Mailing Address - Street 2:#1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-6002
Mailing Address - Country:US
Mailing Address - Phone:773-316-5708
Mailing Address - Fax:
Practice Address - Street 1:3404 N BELL AVE
Practice Address - Street 2:#1
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-6002
Practice Address - Country:US
Practice Address - Phone:773-316-5708
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty