Provider Demographics
NPI:1629592852
Name:ELMHURST COLLEGE
Entity Type:Organization
Organization Name:ELMHURST COLLEGE
Other - Org Name:ELMHURST COLLEGE SPEECH-LANGUAGE-HEARING CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:KISSEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-617-3012
Mailing Address - Street 1:190 PROSPECT AVE
Mailing Address - Street 2:CIRCLE HALL, ROOM 210
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-3296
Mailing Address - Country:US
Mailing Address - Phone:630-617-3555
Mailing Address - Fax:630-617-6461
Practice Address - Street 1:190 PROSPECT AVE
Practice Address - Street 2:CIRCLE HALL, ROOM 210
Practice Address - City:ELMHUST
Practice Address - State:IL
Practice Address - Zip Code:60126-3296
Practice Address - Country:US
Practice Address - Phone:630-617-3555
Practice Address - Fax:630-617-6461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-31
Last Update Date:2017-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech