Provider Demographics
NPI:1730851577
Name:ROSE, BARBARA LYNN (MS/SLP)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:LYNN
Last Name:ROSE
Suffix:
Gender:F
Credentials:MS/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 W CANTERBURY LN
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-7014
Mailing Address - Country:US
Mailing Address - Phone:847-507-3132
Mailing Address - Fax:
Practice Address - Street 1:201 W HAWTHORN PKWY
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1430
Practice Address - Country:US
Practice Address - Phone:847-990-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL211804235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist