Individual
CODIE SURRATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 ROOSEVELT RD STE 206, GLEN ELLYN, IL 60137-5839
(630) 423-5935
(630) 545-3630
Mailing address
520 WILSHIRE AVE, GLEN ELLYN, IL 60137-4944
(512) 964-3386
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/20/2016
Last updated
09/11/2024
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