Basic Information
| Provider Information | |||||||||
| NPI: | 1174797112 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHAEFER | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MS CCC/SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3333 N SEMINARY ST | ||||||||
| Address2: | REHABILITATION DEPT | ||||||||
| City: | GALESBURG | ||||||||
| State: | IL | ||||||||
| PostalCode: | 614011251 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3093449600 | ||||||||
| FaxNumber: | 3093449675 | ||||||||
| Practice Location | |||||||||
| Address1: | 3333 N SEMINARY ST | ||||||||
| Address2: | REHABILITATION DEPT | ||||||||
| City: | GALESBURG | ||||||||
| State: | IL | ||||||||
| PostalCode: | 614011251 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3093449600 | ||||||||
| FaxNumber: | 3093449675 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/22/2008 | ||||||||
| LastUpdateDate: | 09/20/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 146.007422 | IL | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.