Provider Demographics
NPI:1760790240
Name:EWERS, JUDITH M (SPEECH/LANGUAGE PATH)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:M
Last Name:EWERS
Suffix:
Gender:F
Credentials:SPEECH/LANGUAGE PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 S LIBERTY DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-9326
Mailing Address - Country:US
Mailing Address - Phone:847-551-9912
Mailing Address - Fax:
Practice Address - Street 1:9 S LIBERTY DR
Practice Address - Street 2:
Practice Address - City:SOUTH BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-9326
Practice Address - Country:US
Practice Address - Phone:847-551-9912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-19
Last Update Date:2010-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2136966235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist