Provider Demographics
NPI:1164512950
Name:SCHECKLONG, DIANE MARIE (MA)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:MARIE
Last Name:SCHECKLONG
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3014 FAIRFIELD LN
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-3291
Mailing Address - Country:US
Mailing Address - Phone:630-236-6971
Mailing Address - Fax:630-236-6972
Practice Address - Street 1:1 LUCINDA AVE
Practice Address - Street 2:NIU SPEECH-LANGUAGE HEARING CLINIC
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-2899
Practice Address - Country:US
Practice Address - Phone:815-753-1481
Practice Address - Fax:815-753-1664
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist