Individual
GRACE SUH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 STEVENSON DR, LINCOLNSHIRE, IL 60069-2824
(847) 415-4000
Mailing address
1277 E THACKER ST APT 204, DES PLAINES, IL 60016-8617
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65117337
—
IL
Enumeration date
10/26/2017
Last updated
10/26/2017
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