Provider Demographics
NPI:1417231515
Name:PAGANO, JAMIE LEE (MS, CCC)
Entity Type:Individual
Prefix:MISS
First Name:JAMIE
Middle Name:LEE
Last Name:PAGANO
Suffix:
Gender:F
Credentials:MS, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 E PENNSYLVANIA CT
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-4281
Mailing Address - Country:US
Mailing Address - Phone:847-525-1848
Mailing Address - Fax:
Practice Address - Street 1:631 E PENNSYLVANIA CT
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4281
Practice Address - Country:US
Practice Address - Phone:847-525-1848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146010385235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist