Provider Demographics
NPI:1598919078
Name:BUSHBACHER, VANESSA (CCC/SLP/L)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:BUSHBACHER
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 1:799 W KENSINGTON RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-1111
Mailing Address - Country:US
Mailing Address - Phone:847-463-8141
Mailing Address - Fax:
Practice Address - Street 1:799 W KENSINGTON RD
Practice Address - Street 2:
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-1111
Practice Address - Country:US
Practice Address - Phone:847-463-8141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist