Provider Demographics
NPI:1043793177
Name:BRADY SPEECH LANGUAGE PATHOLOGY LTD
Entity Type:Organization
Organization Name:BRADY SPEECH LANGUAGE PATHOLOGY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARNELL
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:312-659-7708
Mailing Address - Street 1:5228 S BLACKSTONE AVE
Mailing Address - Street 2:STE Y
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-4106
Mailing Address - Country:US
Mailing Address - Phone:773-493-4000
Mailing Address - Fax:
Practice Address - Street 1:5228 S BLACKSTONE AVE
Practice Address - Street 2:STE Y
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-4106
Practice Address - Country:US
Practice Address - Phone:773-493-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-14
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty