Doctor Name: | MRS. COLLEEN M STARUCK |
NPI Number: | 1144386277 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | 146008486 |
Business Practice Address: | 549 Taylor Ave Glen Ellyn, IL - 601374242 |
Business Phone Number: | 7733543798 |
Business Fax Number: | 6309844484 |
Mailing Address: | 549 Taylor Ave, GLEN ELLYN |
State: | IL |
Postal Code: | 601374242 |
Phone Number: | 7733543798 |
Fax Number: | 6309844484 |
NPI Enumeration Date: | 01/01/2007 |
NPI Last Update Date: | 05/07/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 146008486 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |