Individual
DECEMBER MCCRACKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
850 FOXWORTH BLVD APT 304, LOMBARD, IL 60148-6433
(815) 621-6869
Mailing address
109 S OAKLAND GRV, ELMHURST, IL 60126-3011
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
17-29089
IL
235Z00000X
Speech-Language Pathologist
Primary
146.015565
IL
Other
Enumeration date
05/14/2018
Last updated
09/14/2021
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