Doctor Name: | KELLIROSE MINOGUE |
NPI Number: | 1740610963 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 146.011936 |
Business Practice Address: | 22285 N Pepper Rd Suite 301 Lake Barrington, IL - 600102538 |
Business Phone Number: | 8478420597 |
Business Fax Number: | 8478429882 |
Mailing Address: | 22285 N Pepper Rd, Suite 301 LAKE BARRINGTON |
State: | IL |
Postal Code: | 600102538 |
Phone Number: | 8478420597 |
Fax Number: | 8478429882 |
NPI Enumeration Date: | 11/25/2013 |
NPI Last Update Date: | 11/25/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 146.011936 |
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 |