Individual
CARLY ELIZABETH DEDITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3801 W LAKE AVE, GLENVIEW, IL 60026-1292
(847) 998-6100
Mailing address
5004 PYNDALE DR, MCHENRY, IL 60050-5019
(815) 382-5049
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
242.007861
IL
Other
Enumeration date
08/28/2024
Last updated
06/28/2026
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