Provider Demographics
NPI:1487819306
Name:BATEMAN, ULRICA ELISABETH (MS,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ULRICA
Middle Name:ELISABETH
Last Name:BATEMAN
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 1:227 HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-1814
Mailing Address - Country:US
Mailing Address - Phone:618-410-6097
Mailing Address - Fax:
Practice Address - Street 1:105 W PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:MILLSTADT
Practice Address - State:IL
Practice Address - Zip Code:62260-1127
Practice Address - Country:US
Practice Address - Phone:618-476-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146005583235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist