Provider Demographics
NPI:1376837146
Name:SOLOMON, JUDY A
Entity Type:Individual
Prefix:MS
First Name:JUDY
Middle Name:A
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W EASTMAN ST
Mailing Address - Street 2:100
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-5937
Mailing Address - Country:US
Mailing Address - Phone:847-222-8065
Mailing Address - Fax:
Practice Address - Street 1:120 W EASTMAN ST
Practice Address - Street 2:100
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-5937
Practice Address - Country:US
Practice Address - Phone:847-222-8065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL006057919224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist