Provider Demographics
NPI:1750357562
Name:BYERS SPRAETZ, JEANNE RANE (MA CCC SLP)
Entity type:Individual
Prefix:
First Name:JEANNE
Middle Name:RANE
Last Name:BYERS SPRAETZ
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1706 SUPERIOR AVE
Mailing Address - Street 2:
Mailing Address - City:SAVANNA
Mailing Address - State:IL
Mailing Address - Zip Code:61074-2424
Mailing Address - Country:US
Mailing Address - Phone:815-541-1857
Mailing Address - Fax:815-273-4354
Practice Address - Street 1:1706 SUPERIOR AVE
Practice Address - Street 2:
Practice Address - City:SAVANNA
Practice Address - State:IL
Practice Address - Zip Code:61074-2424
Practice Address - Country:US
Practice Address - Phone:815-541-1857
Practice Address - Fax:815-273-4354
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 7563235Z00000X
IL146 003582235Z00000X
IA00805235Z00000X
WI363 154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist