Healthcare Provider Details

I. General information

NPI: 1285540773
Provider Name (Legal Business Name): GRACE LADD M.S., CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14315 108TH AVE STE 230
ORLAND PARK IL
60467-5701
US

IV. Provider business mailing address

671 TURTLEDOVE LN
NEW LENOX IL
60451-8301
US

V. Phone/Fax

Practice location:
  • Phone: 708-675-2100
  • Fax:
Mailing address:
  • Phone: 708-821-5039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number242.018975
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: