Provider Demographics
NPI:1205341674
Name:OESTERREICH, GAYLENE MARIE (MA CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:GAYLENE
Middle Name:MARIE
Last Name:OESTERREICH
Suffix:
Gender:F
Credentials:MA CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14740 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-2513
Mailing Address - Country:US
Mailing Address - Phone:847-577-4500
Mailing Address - Fax:
Practice Address - Street 1:14740 MEADOW LN
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-2513
Practice Address - Country:US
Practice Address - Phone:815-577-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-07
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.003854235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty