Healthcare Provider Details

I. General information

NPI: 1407326887
Provider Name (Legal Business Name): GRACE ZAABEL M.A., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GRACE WESSEL

II. Dates (important events)

Enumeration Date: 11/28/2018
Last Update Date: 04/21/2023
Certification Date: 04/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1675 DEMPSTER ST FL 3
PARK RIDGE IL
60068-1110
US

IV. Provider business mailing address

29373 NETWORK PL
CHICAGO IL
60673-1293
US

V. Phone/Fax

Practice location:
  • Phone: 847-318-9330
  • Fax:
Mailing address:
  • Phone: 847-390-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number146.014171
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: