Provider Demographics
NPI:1265082556
Name:TADDEUCCI, MEGAN ANNE
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:ANNE
Last Name:TADDEUCCI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1665 ABINGTON LN
Mailing Address - Street 2:
Mailing Address - City:NORTH AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60542-1749
Mailing Address - Country:US
Mailing Address - Phone:630-940-9596
Mailing Address - Fax:
Practice Address - Street 1:2500 CABOT DR
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-3711
Practice Address - Country:US
Practice Address - Phone:630-864-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-18
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.015837235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist