Individual
MS. DIANE M. MACISAAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MCD,CCC-SLP
Contact information
Practice address
962 GARDEN LN, WHEELING, IL 60090-5513
(847) 537-8055
Mailing address
962 GARDEN LN, WHEELING, IL 60090-5513
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146000499
IL
Other
Enumeration date
07/15/2009
Last updated
05/06/2013
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