Doctor Name: | JEANNINE STUPKA |
NPI Number: | 1700279569 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. CCC-SLP |
License Number: | SP 19031 |
Business Practice Address: | 5002 Main St Suite 4 Downers Grove, IL - 605153659 |
Business Phone Number: | 6309290122 |
Business Fax Number: | |
Mailing Address: | 5002 Main St, Suite 4 DOWNERS GROVE |
State: | IL |
Postal Code: | 605153659 |
Phone Number: | 6309290122 |
Fax Number: | |
NPI Enumeration Date: | 03/17/2015 |
NPI Last Update Date: | 03/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP 19031 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
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 |