Mary Theresa Vandiver, is a
Speech-language Pathologist based in Heyworth, Illinois. Mary Theresa Vandiver is licensed to practice in Illinois (license number 146.006321) and her current practice location is
100 S Joselyn St, Heyworth, Illinois. She can be reached at her office (for appointments etc.) via phone at
(309) 473-2822.
NPI number for Mary Theresa Vandiver is 1063928430 and her current mailing address is 100 S Joselyn St, Heyworth, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1063928430.
Healthcare Provider's Profile
Full Name | Mary Theresa Vandiver |
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Gender | Female |
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Speciality | Speech-language Pathologist |
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Location | 100 S Joselyn St, Heyworth, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1063928430
- Provider Enumeration Date: 12/21/2017
- Last Update Date: 12/21/2017
Medical Identifiers
Medical identifiers for Mary Theresa Vandiver such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1063928430 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
235Z00000X | Speech-language Pathologist | 146.006321 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mary Theresa Vandiver is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mary Theresa Vandiver, 100 S Joselyn St, Heyworth, IL 61745-9191 Ph: (309) 473-2822 | Mary Theresa Vandiver, 100 S Joselyn St, Heyworth, IL 61745-9191 Ph: (309) 473-2822 |
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