Individual ProviderAmanda Joan DasticeSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address2043 W Iowa St Apt 1e, Chicago, IL 60622-5171(708) 653-7122PECOS EnrollmentBased on the most recent information from CMS, provider Amanda Joan Dastice does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1548958507Provider TypeIndividualFull NameDastice, Amanda JoanGenderFemaleSole ProprietorYesEnumeration Date4/27/2023Last Updated4/27/2023Contact InformationPractice LocationPractice Address2043 W Iowa St Apt 1e, Chicago, IL 60622-5171Phone(708) 653-7122FaxUnlisted FaxMailing LocationMailing Address2043 W Iowa St Apt 1e, Chicago, IL 60622-5171Phone(708) 653-7122FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicenseUnlisted IssuerIllinois