Provider Demographics
NPI:1760043806
Name:SMITH, HALLEMA (MHS,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:HALLEMA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:MHS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 E WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-3765
Mailing Address - Country:US
Mailing Address - Phone:309-648-0074
Mailing Address - Fax:
Practice Address - Street 1:140 N WRIGHT ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-4748
Practice Address - Country:US
Practice Address - Phone:630-355-6533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.013444235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist