Provider Demographics
NPI:1306178504
Name:GRIFFONE, REBECCA J (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:J
Last Name:GRIFFONE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:J
Other - Last Name:GRIFFONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:136 CUTTER LN
Mailing Address - Street 2:
Mailing Address - City:LK BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-1550
Mailing Address - Country:US
Mailing Address - Phone:224-633-9382
Mailing Address - Fax:
Practice Address - Street 1:136 CUTTER LN
Practice Address - Street 2:
Practice Address - City:LK BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-1550
Practice Address - Country:US
Practice Address - Phone:224-633-9382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-12
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.010132235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist