Provider Demographics
NPI:1477654655
Name:HUBATCH, LEONA M (PHD, CCC)
Entity Type:Individual
Prefix:
First Name:LEONA
Middle Name:M
Last Name:HUBATCH
Suffix:
Gender:F
Credentials:PHD, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SOUTH 224 SUMMIT AVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-3983
Mailing Address - Country:US
Mailing Address - Phone:630-932-4599
Mailing Address - Fax:630-426-9102
Practice Address - Street 1:1 SOUTH 224 SUMMIT AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-3983
Practice Address - Country:US
Practice Address - Phone:630-932-4599
Practice Address - Fax:630-426-9102
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02232423OtherBC/BS PPO