Provider Demographics
NPI:1801410162
Name:FORBES, MICHELLE ELIZABETH VICTORIA (MS CCC-SLP/L)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ELIZABETH VICTORIA
Last Name:FORBES
Suffix:
Gender:F
Credentials:MS CCC-SLP/L
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:ELIZABETH VICTORIA
Other - Last Name:ESCUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP/L
Mailing Address - Street 1:1406 FAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61571-1122
Mailing Address - Country:US
Mailing Address - Phone:309-472-1347
Mailing Address - Fax:
Practice Address - Street 1:1406 FAYETTE AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IL
Practice Address - Zip Code:61571-1122
Practice Address - Country:US
Practice Address - Phone:309-472-1347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-02
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8414235Z00000X
IL146.016010235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist