Individual
GLORIA TOY RETTKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHS CCC-SLP/L
Contact information
Practice address
1354 W FILLMORE ST, CHICAGO, IL 60607-4807
(312) 315-5172
Mailing address
1354 W FILLMORE ST, UNIT B, CHICAGO, IL 60607-4807
(312) 315-5172
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146007655
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
235Z00000X
—
IL
Enumeration date
06/28/2012
Last updated
06/28/2012
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