Provider Demographics
NPI:1528738168
Name:SPEECH AND LANGUAGE FOR KIDS LLC
Entity type:Organization
Organization Name:SPEECH AND LANGUAGE FOR KIDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:METAXAS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:847-852-0928
Mailing Address - Street 1:3920 N RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-1330
Mailing Address - Country:US
Mailing Address - Phone:847-852-0928
Mailing Address - Fax:302-351-8852
Practice Address - Street 1:3920 N RIDGE AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1330
Practice Address - Country:US
Practice Address - Phone:847-852-0928
Practice Address - Fax:302-351-8852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-15
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty