Healthcare Provider Details

I. General information

NPI: 1104540756
Provider Name (Legal Business Name): ANGELIKA GNIADY SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2022
Last Update Date: 09/28/2022
Certification Date: 09/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 REMINGTON RD STE K
SCHAUMBURG IL
60173-4800
US

IV. Provider business mailing address

8201 CASS AVE
DARIEN IL
60561-5314
US

V. Phone/Fax

Practice location:
  • Phone: 847-496-5513
  • Fax:
Mailing address:
  • Phone: 630-590-5571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: