Provider Demographics
NPI:1417245085
Name:ANDERSON, RUDI JASMINE
Entity Type:Individual
Prefix:MISS
First Name:RUDI
Middle Name:JASMINE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 MATTHEW LN
Mailing Address - Street 2:UNIT B2
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-2854
Mailing Address - Country:US
Mailing Address - Phone:708-957-7706
Mailing Address - Fax:
Practice Address - Street 1:3010 MATTHEW LN
Practice Address - Street 2:UNIT B2
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-2854
Practice Address - Country:US
Practice Address - Phone:708-957-7706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-18
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant