Provider Demographics
NPI:1326282526
Name:YEAGER, ANDREA (MA, CCC-SLP/L)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:YEAGER
Suffix:
Gender:F
Credentials:MA, CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6812 JOLIET RD
Mailing Address - Street 2:UNIT 6
Mailing Address - City:INDIAN HEAD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60525-9019
Mailing Address - Country:US
Mailing Address - Phone:773-447-7867
Mailing Address - Fax:
Practice Address - Street 1:6812 JOLIET RD
Practice Address - Street 2:UNIT 6
Practice Address - City:INDIAN HEAD PARK
Practice Address - State:IL
Practice Address - Zip Code:60525-9019
Practice Address - Country:US
Practice Address - Phone:773-447-7867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-01
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.007443235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist