Provider First Line Business Practice Location Address:
1 LUCINDA AVE
Provider Second Line Business Practice Location Address:
NORTHERN ILLINOIS UNIV. SPEECH-LANGUAGE-HEARING CLINIC
Provider Business Practice Location Address City Name:
DEKALB
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60115-2899
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
815-753-1483
Provider Business Practice Location Address Fax Number:
815-753-1664
Provider Enumeration Date:
10/12/2006