Provider Demographics
NPI:1881847218
Name:FITZGERALD, EILEEN L (AUDITORYORALSPECIALI)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:L
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:AUDITORYORALSPECIALI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1019 E ELM ST
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-6645
Mailing Address - Country:US
Mailing Address - Phone:630-653-8244
Mailing Address - Fax:
Practice Address - Street 1:1019 E ELM ST
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-6645
Practice Address - Country:US
Practice Address - Phone:630-653-8244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235500000X235500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist