Provider Demographics
NPI:1669548749
Name:POWERS, LEANNE SUE (MS)
Entity type:Individual
Prefix:MRS
First Name:LEANNE
Middle Name:SUE
Last Name:POWERS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:LEANNE
Other - Middle Name:SUE
Other - Last Name:EARL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:1114 BUCKINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-4317
Mailing Address - Country:US
Mailing Address - Phone:630-289-2098
Mailing Address - Fax:
Practice Address - Street 1:2781 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-3280
Practice Address - Country:US
Practice Address - Phone:630-355-5444
Practice Address - Fax:630-355-5445
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02232901OtherBCBS
IL02232901OtherBCBS