Provider Demographics
NPI:1447328554
Name:REED, JAN A (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JAN
Middle Name:A
Last Name:REED
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:JAN
Other - Middle Name:
Other - Last Name:POTTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2423 GIRARD TURN
Mailing Address - Street 2:
Mailing Address - City:KANKAKEE
Mailing Address - State:IL
Mailing Address - Zip Code:60901-7360
Mailing Address - Country:US
Mailing Address - Phone:815-933-7092
Mailing Address - Fax:
Practice Address - Street 1:2423 GIRARD TURN
Practice Address - Street 2:
Practice Address - City:KANKAKEE
Practice Address - State:IL
Practice Address - Zip Code:60901-7360
Practice Address - Country:US
Practice Address - Phone:815-933-7092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist