Doctor Name: | MR. DAVID I. DECKER |
NPI Number: | 1477809564 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 146.002865 |
Business Practice Address: | 500 W Court St Kankakee, IL - 609013661 |
Business Phone Number: | 8159372278 |
Business Fax Number: | |
Mailing Address: | 500 W Court St, KANKAKEE |
State: | IL |
Postal Code: | 609013661 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/26/2012 |
NPI Last Update Date: | 07/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 146.002865 |
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 |