Individual
MRS. CYNTHIA JANE GERECKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP/L
Contact information
Practice address
940 WESTERN AVE, FLOSSMOOR, IL 60422-1366
(708) 647-7418
Mailing address
41 E ELMWOOD DR, CHICAGO HEIGHTS, IL 60411-1104
(708) 647-7418
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.003816
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396962106
—
IL
Enumeration date
12/12/2017
Last updated
12/12/2017
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