Provider Demographics
NPI:1346367851
Name:GIUDICE, RITA A (SPT)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:A
Last Name:GIUDICE
Suffix:
Gender:F
Credentials:SPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4482 SAINT TROPEZ DR
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-1056
Mailing Address - Country:US
Mailing Address - Phone:630-717-8208
Mailing Address - Fax:
Practice Address - Street 1:4482 SAINT TROPEZ DR
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-1056
Practice Address - Country:US
Practice Address - Phone:630-717-8208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0002232904OtherSPEECH