Provider Demographics
NPI:1437798741
Name:JENNIFER ANN SPEECH THERAPY, INC
Entity Type:Organization
Organization Name:JENNIFER ANN SPEECH THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SCHOONOVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-420-1901
Mailing Address - Street 1:2009 W WALTON ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-4961
Mailing Address - Country:US
Mailing Address - Phone:312-420-1901
Mailing Address - Fax:
Practice Address - Street 1:2009 W WALTON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-4961
Practice Address - Country:US
Practice Address - Phone:312-420-1901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-03
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty