Doctor Name: | MS. LISA ELIZABETH VANSELOW |
NPI Number: | 1629340096 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. |
License Number: | 146.011474 |
Business Practice Address: | 1442 Old Skokie Rd Highland Park, IL - 600353032 |
Business Phone Number: | 8774864140 |
Business Fax Number: | 8474864145 |
Mailing Address: | 1308 Waukegan Rd, Suite 103 GLENVIEW |
State: | IL |
Postal Code: | 600253070 |
Phone Number: | 8474864140 |
Fax Number: | 8474864145 |
NPI Enumeration Date: | 02/01/2012 |
NPI Last Update Date: | 02/15/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 146.011474 |
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 |