Provider Demographics
NPI:1427695816
Name:DM SPEECH THERAPY LLC
Entity type:Organization
Organization Name:DM SPEECH THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOMINIKA
Authorized Official - Middle Name:NOEMI
Authorized Official - Last Name:MATUZIK
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP/L, PEL
Authorized Official - Phone:224-628-5823
Mailing Address - Street 1:622 COBBLESTONE CIR APT F
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-3840
Mailing Address - Country:US
Mailing Address - Phone:224-628-5823
Mailing Address - Fax:
Practice Address - Street 1:2516 WAUKEGAN RD STE 206
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-1774
Practice Address - Country:US
Practice Address - Phone:224-628-5823
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-04
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty