Provider Demographics
NPI:1619507506
Name:BACHMANN, ALEXIS ELISABETH (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ALEXIS
Middle Name:ELISABETH
Last Name:BACHMANN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-1785
Mailing Address - Country:US
Mailing Address - Phone:847-949-2720
Mailing Address - Fax:
Practice Address - Street 1:200 W MAPLE AVE
Practice Address - Street 2:
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-1785
Practice Address - Country:US
Practice Address - Phone:847-949-2720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-20
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146015004235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist