Provider Demographics
NPI:1972154680
Name:DRISCOLL, MARGARET (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:DRISCOLL
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:
Other - Last Name:O'SHEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:14848 KOSTNER AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:IL
Mailing Address - Zip Code:60445-3241
Mailing Address - Country:US
Mailing Address - Phone:708-612-0185
Mailing Address - Fax:
Practice Address - Street 1:7825 W 103RD ST
Practice Address - Street 2:
Practice Address - City:PALOS HILLS
Practice Address - State:IL
Practice Address - Zip Code:60465-1676
Practice Address - Country:US
Practice Address - Phone:708-598-5509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-24
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146011437235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist