Provider Demographics
NPI:1467790170
Name:SCHLAIS, SUSAN ELAINE (MS CCC--SLP)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:ELAINE
Last Name:SCHLAIS
Suffix:
Gender:F
Credentials:MS CCC--SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3414 MEADOW CREST CIR
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-3775
Mailing Address - Country:US
Mailing Address - Phone:847-599-9631
Mailing Address - Fax:
Practice Address - Street 1:3414 MEADOW CREST CIR
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-3775
Practice Address - Country:US
Practice Address - Phone:847-404-9886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-30
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146009646235Z00000X
WI3447-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist