Individual
MS. CHERYL DENISE DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP-CCC/L
Contact information
Practice address
10438 S MARYLAND AVE, CHICAGO, IL 60628-3090
(773) 552-1670
Mailing address
10438 S MARYLAND AVE, CHICAGO, IL 60628-3090
(773) 552-1670
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146004378
IL
Other
Enumeration date
06/20/2011
Last updated
06/20/2011
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