Organization
SOVEREIGN PEDIATRIC
Active
Organization
SOVEREIGN PEDIATRIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN BINDER MA, SLP (SPEECH PATHOLOGIST)
(630) 370-2711
Entity
Organization
Contact information
Practice address
1990 GREEN TRAILS DR, LISLE, IL 60532-3345
(630) 370-2711
Mailing address
1990 GREEN TRAILS DR, LISLE, IL 60532-3345
(630) 370-2711
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
146.010876
IL
Other
Enumeration date
10/06/2016
Last updated
10/06/2016
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