Provider Demographics
NPI:1801299821
Name:MATEJCAK, ASHLEY MARIE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:MARIE
Last Name:MATEJCAK
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:MARIE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:2170 COUNTRY KNOLL LN
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-4909
Mailing Address - Country:US
Mailing Address - Phone:630-973-9953
Mailing Address - Fax:
Practice Address - Street 1:4015 PLAINFIELD NAPERVILLE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-4238
Practice Address - Country:US
Practice Address - Phone:630-904-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-05
Last Update Date:2014-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.011496235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist