Provider Demographics
NPI:1275100943
Name:SPEECHTACULAR THERAPY, LLC
Entity Type:Organization
Organization Name:SPEECHTACULAR THERAPY, LLC
Other - Org Name:ACCENT ME NOT, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASYA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRENGAUZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:224-565-6166
Mailing Address - Street 1:109 S DEERPATH DR
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-2413
Mailing Address - Country:US
Mailing Address - Phone:224-565-6166
Mailing Address - Fax:
Practice Address - Street 1:109 S DEERPATH DR
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-2413
Practice Address - Country:US
Practice Address - Phone:224-565-6166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-09
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty