Provider Demographics
NPI:1184958894
Name:FELTZ, REBECCA LYNN (SLPA)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:FELTZ
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:LYNN
Other - Last Name:GALLES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SLPA
Mailing Address - Street 1:342 N GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:HINCKLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60520-9787
Mailing Address - Country:US
Mailing Address - Phone:815-286-5166
Mailing Address - Fax:
Practice Address - Street 1:1049 E WILSON ST STE 100
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:IL
Practice Address - Zip Code:60510-2478
Practice Address - Country:US
Practice Address - Phone:630-761-0900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-28
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL217.0002142355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant