TARA CHILDRESS-JACKSON SLPA NPI 1093166373

NPI Information

NPI: 1093166373
Provider Name: TARA CHILDRESS-JACKSON, SLPA
Classification: Specialist/Technologist - 2355S0801X
Entity Type: Individual

Specialization: Speech-Language Assistant

Address:
8819 S FAIRFIELD AVE
EVERGREEN PARK, IL
ZIP 60805
Phone: (312) 758-1463
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Tara Childress-jackson, SLPA is a speech-language assistant specialist technologist in Evergreen Park, IL. Tara Childress-jackson, SLPA NPI is 1093166373. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

8819 S FAIRFIELD AVE
EVERGREEN PARK, IL
ZIP 60805-144
Phone: (312) 758-1463

The enumeration date for this NPI number is 6/28/2016 and was last updated on 6/28/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2355S0801X	Specialist/Technologist	Speech-Language Assistant	217000240	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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