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Organization
PEDIATRIC FUNDAMENTALS,LLC
Active
Organization
PEDIATRIC FUNDAMENTALS,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAUNA J RUZICH MS CCC-SLP (OWNER/MANAGER)
(815) 931-8595
Entity
Organization
Contact information
Practice address
36963 IRISH LN, CUSTER PARK, IL 60481-8420
(815) 931-8595
Mailing address
36963 IRISH LN, CUSTER PARK, IL 60481-8420
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146006731
IL
Other
Enumeration date
05/02/2014
Last updated
05/02/2014
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