Provider Demographics
NPI:1255116232
Name:MCGINNIS, JESSICA ANNE (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANNE
Last Name:MCGINNIS
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4429 HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:WESTERN SPRINGS
Mailing Address - State:IL
Mailing Address - Zip Code:60558-1652
Mailing Address - Country:US
Mailing Address - Phone:301-602-8443
Mailing Address - Fax:
Practice Address - Street 1:ABRAHAM LINCOLN ELEMENTARY SCHOOL
Practice Address - Street 2:380 GREENFIELD AVENUE
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137
Practice Address - Country:US
Practice Address - Phone:630-534-7572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2618750235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist