| NPI | 1174652614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY A CRUM Speech Pathologist 312-642-4300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: IL 056004206) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IL 146.005733) |
| 235Z00000X Speech-Language Pathologist, (Licence: IL 146.006643) | |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2020-08-22 |