Provider Demographics
NPI:1023824281
Name:TOWERS, MADISON (CCC-SLP)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:TOWERS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:MADISON
Other - Middle Name:
Other - Last Name:ALLARDYCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:512 CANARY LN
Mailing Address - Street 2:
Mailing Address - City:CARTERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62918-1650
Mailing Address - Country:US
Mailing Address - Phone:618-694-6434
Mailing Address - Fax:
Practice Address - Street 1:3333 W DEYOUNG ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-5884
Practice Address - Country:US
Practice Address - Phone:618-998-7918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146017065235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist