Provider Demographics
NPI:1154526119
Name:BLUDGEN, ANNE KATHRYN (MHS CCC SLP)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:KATHRYN
Last Name:BLUDGEN
Suffix:
Gender:F
Credentials:MHS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15000 COTTAGE GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:DOLTON
Mailing Address - State:IL
Mailing Address - Zip Code:60419-2738
Mailing Address - Country:US
Mailing Address - Phone:708-271-4451
Mailing Address - Fax:
Practice Address - Street 1:15000 COTTAGE GROVE AVE
Practice Address - Street 2:
Practice Address - City:DOLTON
Practice Address - State:IL
Practice Address - Zip Code:60419-2738
Practice Address - Country:US
Practice Address - Phone:708-271-4451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146-005469235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist