Provider Demographics
NPI:1639293962
Name:SAUNDERS, PHYLLIS
Entity type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 UNION DR
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60466-3033
Mailing Address - Country:US
Mailing Address - Phone:708-534-0987
Mailing Address - Fax:708-534-3987
Practice Address - Street 1:814 UNION DR
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PARK
Practice Address - State:IL
Practice Address - Zip Code:60466-3033
Practice Address - Country:US
Practice Address - Phone:708-534-0987
Practice Address - Fax:708-534-3987
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist