Susan Anderson
Individual provider Active NPI Speech-Language Pathologist · South Holland, IL
NPI 1356980783 · NPPES record last updated Jan 28, 2021
Key facts
- NPI
- 1356980783
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 146.015788 (IL)
- Practice address
- 350 W 154TH St
South Holland, IL 60473-1229 - Phone
- (708) 333-7880
- NPI assigned
- Jan 2, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146.015788 | IL | MD | Speech-Language Pathologist |
| 242.005696 | IL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Exceptional Children Have Echo Joint Agreement | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 242.005696 | IL | |
| Speech-Language Pathologist | 235Z00000X | 146.015788 | IL | Yes |
Addresses
Primary practice location
350 W 154TH St
South Holland, IL 60473-1229
Mailing address
18535 Miller Dr
Lansing, IL 60438-3311
Phone (630) 303-6018
Other practice location 1
18535 Miller Dr
Lansing, IL 60438-3311
Phone (708) 858-0595
Other providers in South Holland, IL
- Safiat Amuwo
- Anderson Clinical Services Corp
- Ashley Elizabeth Anderson
- La Tonya Anderson
- Naquesha Anderson
- Maxwell Anokwute
- Arden Courts of South Holland Il LLC
- Artistic Dental Centre
- Ashley Medical Supply LLC
- Janiese Myesha Asque
All providers in South Holland, IL · Speech-Language Pathologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.