| NPI | 1114018751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOLLY ANN GUMMERSON Treasurer 773-316-5708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 146-006085) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2020-08-22 |