Individual
DENISE THERESE FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14950 LARAMIE AVE, OAK FOREST, IL 60452-1323
(708) 687-2860
Mailing address
6020 151ST ST, OAK FOREST, IL 60452-1841
(708) 687-0900
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1929045
IL
235Z00000X
Speech-Language Pathologist
1929045
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
70715611
—
IL
Enumeration date
12/19/2017
Last updated
12/19/2017
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