Provider Demographics
NPI:1235253188
Name:OWENS, LINDA L (SPEECH PATHOLOGIST)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:L
Last Name:OWENS
Suffix:
Gender:F
Credentials:SPEECH PATHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17604 SURREY LN
Mailing Address - Street 2:
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-2068
Mailing Address - Country:US
Mailing Address - Phone:708-870-8805
Mailing Address - Fax:708-798-5691
Practice Address - Street 1:17604 SURREY LN
Practice Address - Street 2:
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-2068
Practice Address - Country:US
Practice Address - Phone:708-870-8805
Practice Address - Fax:708-798-5691
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist