Provider Demographics
NPI:1487747259
Name:SWEENEY, JANA JANEESE (CCC/SLP-L)
Entity type:Individual
Prefix:
First Name:JANA
Middle Name:JANEESE
Last Name:SWEENEY
Suffix:
Gender:F
Credentials: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 1:5651 N COUNTY ROAD 2100E
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:IL
Mailing Address - Zip Code:61920-8571
Mailing Address - Country:US
Mailing Address - Phone:217-348-7821
Mailing Address - Fax:
Practice Address - Street 1:5651 N COUNTY ROAD 2100E
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:IL
Practice Address - Zip Code:61920-8571
Practice Address - Country:US
Practice Address - Phone:217-348-7821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist