Provider Demographics
NPI:1346672524
Name:STRUGALLA, EDWARD ANTHONY (MHS, CCC-SLP/L)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:ANTHONY
Last Name:STRUGALLA
Suffix:
Gender:M
Credentials:MHS, 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 1:38W930 MCNAIR DR
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-6176
Mailing Address - Country:US
Mailing Address - Phone:630-404-3652
Mailing Address - Fax:
Practice Address - Street 1:1001 E WILSON ST STE 100
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:IL
Practice Address - Zip Code:60510-3157
Practice Address - Country:US
Practice Address - Phone:630-761-0900
Practice Address - Fax:630-761-0909
Is Sole Proprietor?:No
Enumeration Date:2013-07-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.012303235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist