Provider Demographics
NPI:1215183272
Name:BEYER, NORMAN LEON (SLP/AUD)
Entity Type:Individual
Prefix:MR
First Name:NORMAN
Middle Name:LEON
Last Name:BEYER
Suffix:
Gender:M
Credentials:SLP/AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 W NORTH ST
Mailing Address - Street 2:
Mailing Address - City:BRADLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60915-1013
Mailing Address - Country:US
Mailing Address - Phone:815-937-3707
Mailing Address - Fax:815-937-8061
Practice Address - Street 1:700 W NORTH ST
Practice Address - Street 2:
Practice Address - City:BRADLEY
Practice Address - State:IL
Practice Address - Zip Code:60915-1013
Practice Address - Country:US
Practice Address - Phone:815-937-3707
Practice Address - Fax:815-937-8061
Is Sole Proprietor?:No
Enumeration Date:2008-08-11
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147.000260231H00000X
IL146.001755235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist