Provider Demographics
NPI:1962151332
Name:MADISON PAIGE SPEECH AND LANGUAGE THERAPY INC.
Entity type:Organization
Organization Name:MADISON PAIGE SPEECH AND LANGUAGE THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAMORROW
Authorized Official - Middle Name:ANIESE
Authorized Official - Last Name:GRIFFITH
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:708-852-3096
Mailing Address - Street 1:17687 PHEASANT LN
Mailing Address - Street 2:
Mailing Address - City:COUNTRY CLUB HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60478-4981
Mailing Address - Country:US
Mailing Address - Phone:708-990-5674
Mailing Address - Fax:
Practice Address - Street 1:17687 PHEASANT LANE
Practice Address - Street 2:
Practice Address - City:COUNTRY CLUB HILLS
Practice Address - State:IL
Practice Address - Zip Code:60478
Practice Address - Country:US
Practice Address - Phone:708-852-3096
Practice Address - Fax:708-852-3101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-22
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty