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General NPI Number Information
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NPI Number | 1699013219
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Entity Type | Organization
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Legal Business Name | GRADY COONEY SPEECH PARTNERS, LTD
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Dates
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Enumeration Date | 01/17/2013
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Last Update Date | 10/18/2019
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Provider Practice Location Address
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Address Line | 4560 W 103RD ST UNIT 2
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City | OAK LAWN
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State | IL
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Zip | 60453-4869
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Country | US
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Telephone | 773-841-8180
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Fax |
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Provider Business Mailing Address
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Address Line | 4560 W 103RD ST UNIT 2
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City | OAK LAWN
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State | IL
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Zip | 60453-4869
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MAUREEN GRADY COONEY
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Credential | MS, CCC-SLP, COM
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Telephone | 773-841-8180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 68557372
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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