Provider Demographics
NPI:1922039510
Name:HILLS, ANDREA M (MS CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:M
Last Name:HILLS
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8 DOCTORS PARK RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:IL
Mailing Address - Zip Code:62864-6224
Mailing Address - Country:US
Mailing Address - Phone:618-241-8753
Mailing Address - Fax:618-241-8759
Practice Address - Street 1:8 DOCTORS PARK RD
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:IL
Practice Address - Zip Code:62864-6224
Practice Address - Country:US
Practice Address - Phone:618-241-8753
Practice Address - Fax:618-241-8759
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146002102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4127717Medicare UPIN