Amanda'S Slp Care LLC
Speech-Language Pathologist, in O Fallon, IL. Organization (NPI-2).
NPI number1457789786
StatusActive
Last updated in NPPESFeb 27, 2015
Details
- NPI
- 1457789786
- Entity type
- Organization (NPI-2)
- Legal business name
- Amanda'S Slp Care LLC
- Organization subpart
- No
- Enumeration date
- Oct 23, 2013
- Last updated
- Feb 27, 2015
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | 146.011341 | IL | Yes |
Practice location
8 Eagle Ctr Ste 5O Fallon, IL 62269-1947
Phone 618-334-4550 · Fax 877-418-7178
Mailing address
8 Eagle Ctr Ste 5O Fallon, IL 62269-1947
Phone 618-334-4550 · Fax 877-418-7178
Authorized official
Amanda Johnson
Owner
6183344550
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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