Provider Demographics
NPI:1831731710
Name:ENLIGHTENED SPEECH AND LANGUAGE, LLC
Entity type:Organization
Organization Name:ENLIGHTENED SPEECH AND LANGUAGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HESCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-855-7037
Mailing Address - Street 1:2151 W CORTEZ ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-3602
Mailing Address - Country:US
Mailing Address - Phone:574-855-7037
Mailing Address - Fax:
Practice Address - Street 1:2151 W CORTEZ ST UNIT 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-3602
Practice Address - Country:US
Practice Address - Phone:574-855-7037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-12
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty