1144372814 NPI number — JENNIFER DAWN BARON MA CCC SLP

Table of content: JENNIFER DAWN BARON MA CCC SLP (NPI 1144372814)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144372814 NPI number — JENNIFER DAWN BARON MA CCC SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARON
Provider First Name:
JENNIFER
Provider Middle Name:
DAWN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA CCC SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ZEHR
Provider Other First Name:
JENNIFER
Provider Other Middle Name:
DAWN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA CCC SLP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1144372814
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1049 EAST WILSON STREET
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
BATAVIA
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60510
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-761-0900
Provider Business Mailing Address Fax Number:
630-761-0909

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1049 EAST WILSON STREET
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
BATAVIA
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-761-0900
Provider Business Practice Location Address Fax Number:
630-761-0909
Provider Enumeration Date:
01/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  146006668 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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