Provider Demographics
NPI:1295955623
Name:HORBUS, MARILYN JEAN (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:JEAN
Last Name:HORBUS
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 1:629 SYLVAN CT
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:IL
Mailing Address - Zip Code:60510-3295
Mailing Address - Country:US
Mailing Address - Phone:630-879-2698
Mailing Address - Fax:
Practice Address - Street 1:629 SYLVAN CT
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:IL
Practice Address - Zip Code:60510-3295
Practice Address - Country:US
Practice Address - Phone:630-879-2698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
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