Provider Demographics
NPI:1104632322
Name:PARSONS, ALICIA ANN (SLP)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:ANN
Last Name:PARSONS
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 1:4609 PUFFER RD
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-3207
Mailing Address - Country:US
Mailing Address - Phone:630-703-4407
Mailing Address - Fax:
Practice Address - Street 1:4609 PUFFER RD
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-3207
Practice Address - Country:US
Practice Address - Phone:630-703-4407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.008144235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist