Provider Demographics
NPI:1861528937
Name:TERESA KAY ARMSTRONG
Entity type:Organization
Organization Name:TERESA KAY ARMSTRONG
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSED SPEECH LANGUAGE PATH.
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:MACCCSLP
Authorized Official - Phone:630-801-9909
Mailing Address - Street 1:79 RED FOX RUN
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:IL
Mailing Address - Zip Code:60538-2913
Mailing Address - Country:US
Mailing Address - Phone:630-801-9909
Mailing Address - Fax:630-801-9929
Practice Address - Street 1:79 RED FOX RUN
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:IL
Practice Address - Zip Code:60538-2913
Practice Address - Country:US
Practice Address - Phone:630-801-9909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-25
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146002576235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty