Provider Demographics
NPI:1285983957
Name:MCCARTHY, MAUREEN GLORIA (MA, CCC/SLP-L)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:GLORIA
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:MA, CCC/SLP-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 LOCHBROOK LN
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:IL
Mailing Address - Zip Code:60010-5436
Mailing Address - Country:US
Mailing Address - Phone:847-842-0225
Mailing Address - Fax:
Practice Address - Street 1:500 COVENTRY LN
Practice Address - Street 2:SUITE 170
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-7579
Practice Address - Country:US
Practice Address - Phone:815-356-2700
Practice Address - Fax:815-356-2709
Is Sole Proprietor?:No
Enumeration Date:2012-09-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146-003863235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist