Provider Demographics
NPI:1720687726
Name:ALBERTZ, EMILY ANNE (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ANNE
Last Name:ALBERTZ
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 N SHARON DR
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098-3052
Mailing Address - Country:US
Mailing Address - Phone:815-814-6068
Mailing Address - Fax:
Practice Address - Street 1:350 W SCHAUMBURG RD
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60194-3464
Practice Address - Country:US
Practice Address - Phone:847-884-5832
Practice Address - Fax:847-755-2001
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.015511235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist