Provider Demographics
NPI:1700405388
Name:PREDL, EMILIE ANNE
Entity Type:Individual
Prefix:MISS
First Name:EMILIE
Middle Name:ANNE
Last Name:PREDL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9340 S 82ND CT
Mailing Address - Street 2:
Mailing Address - City:HICKORY HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60457-1916
Mailing Address - Country:US
Mailing Address - Phone:708-567-5378
Mailing Address - Fax:
Practice Address - Street 1:3350 W SALT CREEK LN STE 115
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-1089
Practice Address - Country:US
Practice Address - Phone:224-248-9449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-13
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty