Provider Demographics
NPI:1467971663
Name:SACHS, AMY LYNNE (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LYNNE
Last Name:SACHS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 SUNSET CHASE
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:IL
Mailing Address - Zip Code:62294-3231
Mailing Address - Country:US
Mailing Address - Phone:618-254-3148
Mailing Address - Fax:
Practice Address - Street 1:414 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:SOUTH ROXANA
Practice Address - State:IL
Practice Address - Zip Code:62087-1628
Practice Address - Country:US
Practice Address - Phone:618-254-3148
Practice Address - Fax:618-254-3148
Is Sole Proprietor?:No
Enumeration Date:2017-09-19
Last Update Date:2017-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.010768235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist