Provider Demographics
NPI:1912418831
Name:SABAL, JANINE LYNN (MA, CCC)
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:LYNN
Last Name:SABAL
Suffix:
Gender:F
Credentials:MA, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-1032
Mailing Address - Country:US
Mailing Address - Phone:630-640-0576
Mailing Address - Fax:
Practice Address - Street 1:132 E PINE AVE
Practice Address - Street 2:
Practice Address - City:ROSELLE
Practice Address - State:IL
Practice Address - Zip Code:60172-2252
Practice Address - Country:US
Practice Address - Phone:630-894-0490
Practice Address - Fax:630-894-0490
Is Sole Proprietor?:No
Enumeration Date:2017-10-18
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.001480235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist