Provider Demographics
NPI:1245550375
Name:TAINO, MEGHAN JOSEPHINE (MS SLP)
Entity type:Individual
Prefix:MS
First Name:MEGHAN
Middle Name:JOSEPHINE
Last Name:TAINO
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 N LARRABEE ST APT 813
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-7016
Mailing Address - Country:US
Mailing Address - Phone:708-772-0455
Mailing Address - Fax:
Practice Address - Street 1:347 ARBOR GLEN BLVD
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60195-3164
Practice Address - Country:US
Practice Address - Phone:847-530-8943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.001191235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist