Provider Demographics
NPI:1023996659
Name:BUETA, JOY JULIE ANNE (MHS CCC-SLP)
Entity type:Individual
Prefix:
First Name:JOY JULIE ANNE
Middle Name:
Last Name:BUETA
Suffix:
Gender:F
Credentials:MHS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10837 S KOMENSKY AVE
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-5369
Mailing Address - Country:US
Mailing Address - Phone:909-434-4156
Mailing Address - Fax:
Practice Address - Street 1:5110 W 24TH ST
Practice Address - Street 2:
Practice Address - City:CICERO
Practice Address - State:IL
Practice Address - Zip Code:60804-2948
Practice Address - Country:US
Practice Address - Phone:708-863-4856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146016359235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist