Provider Demographics
NPI:1922389121
Name:KEECH, SAUNDRA L (CCC-SLP/L)
Entity type:Individual
Prefix:
First Name:SAUNDRA
Middle Name:L
Last Name:KEECH
Suffix:
Gender:F
Credentials: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 1:2008 TYLER TRL
Mailing Address - Street 2:
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60051-3614
Mailing Address - Country:US
Mailing Address - Phone:847-875-7924
Mailing Address - Fax:
Practice Address - Street 1:13400 S ROUTE 59
Practice Address - Street 2:SUITE 116-326
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60585-5826
Practice Address - Country:US
Practice Address - Phone:815-267-7333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-31
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146010969235Z00000X
CASLP 18883235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist