Provider Demographics
NPI:1740580760
Name:CAMPEAU-SIITARI, LEANN MARIE (SLP)
Entity Type:Individual
Prefix:
First Name:LEANN
Middle Name:MARIE
Last Name:CAMPEAU-SIITARI
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1286 E WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-6507
Mailing Address - Country:US
Mailing Address - Phone:715-271-3296
Mailing Address - Fax:
Practice Address - Street 1:4045 WILSHIRE CIR
Practice Address - Street 2:
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-2985
Practice Address - Country:US
Practice Address - Phone:715-271-3296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.010742235Z00000X
WI3381-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist