Individual
GRACIE LEEANN MCNICOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1003 N DAMEN AVE, CHICAGO, IL 60622-4391
(312) 348-6288
Mailing address
509 W DEMING PL APT 2S, CHICAGO, IL 60614-5946
(406) 291-9226
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
242.008512
IL
Other
Enumeration date
07/24/2025
Last updated
07/24/2025
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