Provider Demographics
NPI:1053798215
Name:THENGIL, JENNIFER ANNE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANNE
Last Name:THENGIL
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:ANNE
Other - Last Name:WINKLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:924 WEEPING WILLOW DR
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-5745
Mailing Address - Country:US
Mailing Address - Phone:847-567-9854
Mailing Address - Fax:
Practice Address - Street 1:924 WEEPING WILLOW DR
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-5745
Practice Address - Country:US
Practice Address - Phone:847-567-9854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-27
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.007167235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist