1245306752 NPI number — MS. SUSAN M RAAD M.A., CCC-SLP

Table of content: MS. SUSAN M RAAD M.A., CCC-SLP (NPI 1245306752)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245306752 NPI number — MS. SUSAN M RAAD M.A., CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAAD
Provider First Name:
SUSAN
Provider Middle Name:
M
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.A., CCC-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245306752
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9S168 LANDSFIELD AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DOWNERS GROVE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60516-4541
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-910-6420
Provider Business Mailing Address Fax Number:
630-495-8200

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2901 FINLEY RD STE 102
Provider Second Line Business Practice Location Address:
COMMUNICATION CLUBHOUSE
Provider Business Practice Location Address City Name:
DOWNERS GROVE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60515-1774
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-495-6800
Provider Business Practice Location Address Fax Number:
630-495-8200
Provider Enumeration Date:
11/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  146004726 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 222Q00000X , with the licence number: 146004726 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com