Provider Demographics
NPI:1609989482
Name:CHAPLIN, BEULAH MAE (SPEECH LANGUAGE PATH)
Entity Type:Individual
Prefix:MRS
First Name:BEULAH
Middle Name:MAE
Last Name:CHAPLIN
Suffix:
Gender:F
Credentials:SPEECH LANGUAGE PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1039 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:ROCHELLE
Mailing Address - State:IL
Mailing Address - Zip Code:61068-1411
Mailing Address - Country:US
Mailing Address - Phone:815-562-4418
Mailing Address - Fax:
Practice Address - Street 1:1039 N 8TH ST
Practice Address - Street 2:
Practice Address - City:ROCHELLE
Practice Address - State:IL
Practice Address - Zip Code:61068-1411
Practice Address - Country:US
Practice Address - Phone:815-562-4418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILBC60280498P235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist