Provider Demographics
NPI:1720135940
Name:PRELLWITZ-BENDING, JULIE M (MS, SLP-CCC)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:M
Last Name:PRELLWITZ-BENDING
Suffix:
Gender:F
Credentials:MS, SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18836 MEADOW GRASS DR
Mailing Address - Street 2:
Mailing Address - City:LAKE VILLA
Mailing Address - State:IL
Mailing Address - Zip Code:60046-6757
Mailing Address - Country:US
Mailing Address - Phone:847-650-2925
Mailing Address - Fax:847-265-1945
Practice Address - Street 1:18836 MEADOW GRASS DR
Practice Address - Street 2:
Practice Address - City:LAKE VILLA
Practice Address - State:IL
Practice Address - Zip Code:60046-6757
Practice Address - Country:US
Practice Address - Phone:847-650-2925
Practice Address - Fax:847-265-1945
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.006102235Z00000X
WI2062-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04932420OtherBLUE CROSS BLUE SHIELD
IL7947670OtherAETNA