Provider Demographics
NPI:1407095854
Name:PERKINS, JEANNE P (AUD)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:P
Last Name:PERKINS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:487 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-4403
Mailing Address - Country:US
Mailing Address - Phone:630-858-3277
Mailing Address - Fax:630-858-6932
Practice Address - Street 1:487 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-4403
Practice Address - Country:US
Practice Address - Phone:630-858-3277
Practice Address - Fax:630-858-6932
Is Sole Proprietor?:No
Enumeration Date:2009-02-09
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23001854A231H00000X
IL146-001437235Z00000X
IL147-000227231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist