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Organization
SUSAN ANISH P.C.
Active
Organization
SUSAN ANISH P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN E ANISH M.S. CCC-SLP (PRESIDENT / SPEECH THERAPIST)
(773) 467-0063
Entity
Organization
Contact information
Practice address
7658 W FARRAGUT AVE, CHICAGO, IL 60656-1704
(773) 467-0063
Mailing address
7658 W FARRAGUT AVE, CHICAGO, IL 60656-1704
(773) 467-0063
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01633987
BLUE SHIELD PROVIDER #
IL
Enumeration date
04/18/2006
Last updated
08/22/2020
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