Provider Demographics
NPI:1487297693
Name:NEWBILL, MCKENZIE ELIZABETH (CCC, SLP)
Entity type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:ELIZABETH
Last Name:NEWBILL
Suffix:
Gender:F
Credentials:CCC, SLP
Other - Prefix:
Other - First Name:MCKENZIE
Other - Middle Name:ELIZABETH
Other - Last Name:MEARES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC, SLP
Mailing Address - Street 1:780 SHORELINE DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-6192
Mailing Address - Country:US
Mailing Address - Phone:630-375-3030
Mailing Address - Fax:630-375-3029
Practice Address - Street 1:780 SHORELINE DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-6192
Practice Address - Country:US
Practice Address - Phone:630-375-3030
Practice Address - Fax:630-375-3029
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2448862235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty