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NPI Code Detail

MEDICARE: GRACE ROCHFORD CCC-SLP

MEDICARE: GRACE ROCHFORD CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist146017698IL

General Provider Information

NPI Number : 1386468346
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACE ROCHFORD CCC-SLP
Provider Business Mailing Address
First Line : 0N437 PRESCOTT DR
Second Line :
City : WINFIELD
State : IL
Zip : 60190-2102
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1551 LAKE COOK RD
Second Line :
City : DEERFIELD
State : IL
Zip : 60015-5651
Country : US
Telephone Number : 847-374-0500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2024
Last Update Date : 11/14/2024

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Directions to “ GRACE ROCHFORD CCC-SLP” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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