Lake, Mary T

Lake, Mary T is an sole proprietor health care provider with primary practice located at 15700 Terrace Dr # P102 , Oak Forest IL 60452-2959. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Lake, Mary T can be contacted via phone (708) 717-4924.

Contact Information

Primary practice address
15700 Terrace Dr # P102 Oak Forest IL 60452-2959
Phone: (708) 717-4924
Fax: (815) 464-8431
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X Illinois

Profile Details

NPI number 1821203100
LBN Legal business name Lake, Mary T
Credentials SLP
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 11th, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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