Provider Demographics
NPI:1689811010
Name:SCHULTZ, JANELLE JEAN (MA, CCC-SLP/L)
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:JEAN
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:MA, 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 1:22702 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:MARENGO
Mailing Address - State:IL
Mailing Address - Zip Code:60152-9280
Mailing Address - Country:US
Mailing Address - Phone:847-644-6113
Mailing Address - Fax:
Practice Address - Street 1:22702 RIVER RD
Practice Address - Street 2:
Practice Address - City:MARENGO
Practice Address - State:IL
Practice Address - Zip Code:60152-9280
Practice Address - Country:US
Practice Address - Phone:847-644-6113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-07
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146010037235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist