Provider Demographics
NPI:1730402777
Name:PALMER, SEANA (MS CCC/SLP-L)
Entity type:Individual
Prefix:
First Name:SEANA
Middle Name:
Last Name:PALMER
Suffix:
Gender:F
Credentials:MS CCC/SLP-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14060 CHICORY TRL
Mailing Address - Street 2:
Mailing Address - City:HOMER GLEN
Mailing Address - State:IL
Mailing Address - Zip Code:60491-9464
Mailing Address - Country:US
Mailing Address - Phone:224-523-0487
Mailing Address - Fax:
Practice Address - Street 1:3701 168TH ST
Practice Address - Street 2:
Practice Address - City:COUNTRY CLUB HILLS
Practice Address - State:IL
Practice Address - Zip Code:60478-2123
Practice Address - Country:US
Practice Address - Phone:708-335-9770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-04
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.009954235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist