Provider Demographics
NPI:1932314952
Name:THE SPEECH EXCEL CENTER, INC.
Entity Type:Organization
Organization Name:THE SPEECH EXCEL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNADETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, CCC-SLP
Authorized Official - Phone:312-949-1918
Mailing Address - Street 1:401 E 32ND ST
Mailing Address - Street 2:RM. 204
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-4052
Mailing Address - Country:US
Mailing Address - Phone:312-949-1918
Mailing Address - Fax:312-949-1359
Practice Address - Street 1:401 E 32ND ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-4052
Practice Address - Country:US
Practice Address - Phone:312-907-3634
Practice Address - Fax:312-949-1359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL328446692001Medicaid