Provider Demographics
NPI:1558502666
Name:EPPLEY, MICHELLE (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:EPPLEY
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 MIDWEST RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1342
Mailing Address - Country:US
Mailing Address - Phone:630-435-5622
Mailing Address - Fax:630-953-8687
Practice Address - Street 1:2021 MIDWEST RD
Practice Address - Street 2:SUITE 200
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1342
Practice Address - Country:US
Practice Address - Phone:630-435-5622
Practice Address - Fax:630-953-8687
Is Sole Proprietor?:No
Enumeration Date:2009-03-19
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146005646235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist