Provider Demographics
NPI:1699286187
Name:SCALES, ROBERTA (SLP/CCC)
Entity type:Individual
Prefix:
First Name:ROBERTA
Middle Name:
Last Name:SCALES
Suffix:
Gender:F
Credentials:SLP/CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 S LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-4006
Mailing Address - Country:US
Mailing Address - Phone:630-546-8349
Mailing Address - Fax:
Practice Address - Street 1:4100 SCOVILLE AVE
Practice Address - Street 2:
Practice Address - City:STICKNEY
Practice Address - State:IL
Practice Address - Zip Code:60402-4428
Practice Address - Country:US
Practice Address - Phone:708-783-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist