Provider Demographics
NPI:1063729168
Name:GOVEA, ANNIE (SPT)
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:
Last Name:GOVEA
Suffix:
Gender:F
Credentials:SPT
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:
Other - Last Name:MATHEW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:939 N PLUM GROVE RD SUITE G
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4775
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:939 N PLUM GROVE RD SUITE G
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4775
Practice Address - Country:US
Practice Address - Phone:847-517-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-10
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.009346235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist