Individual
DEEPA VADAKEDOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7643 CHURCH ST, MORTON GROVE, IL 60053-1618
(469) 258-5926
Mailing address
7643 CHURCH ST, MORTON GROVE, IL 60053-1618
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146011402
IL
Other
Enumeration date
06/07/2013
Last updated
06/07/2013
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