Provider Demographics
NPI:1063079119
Name:PARTIPILO, MARIE ASHLEY (SLP)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:ASHLEY
Last Name:PARTIPILO
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:469 PINECROFT DR
Mailing Address - Street 2:
Mailing Address - City:ROSELLE
Mailing Address - State:IL
Mailing Address - Zip Code:60172-2534
Mailing Address - Country:US
Mailing Address - Phone:630-453-7084
Mailing Address - Fax:
Practice Address - Street 1:975 E NERGE RD STE W20
Practice Address - Street 2:
Practice Address - City:ROSELLE
Practice Address - State:IL
Practice Address - Zip Code:60172-4812
Practice Address - Country:US
Practice Address - Phone:224-520-8562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-23
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.013915235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist