Provider Demographics
NPI:1275689705
Name:JAUCH, TAMMY JEAN (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:JEAN
Last Name:JAUCH
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 1:393 OAKMONT DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:IL
Mailing Address - Zip Code:60013-1179
Mailing Address - Country:US
Mailing Address - Phone:630-440-1679
Mailing Address - Fax:847-639-9158
Practice Address - Street 1:393 OAKMONT DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:IL
Practice Address - Zip Code:60013-1179
Practice Address - Country:US
Practice Address - Phone:630-440-1679
Practice Address - Fax:847-639-9158
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist