Provider Demographics
NPI:1497956759
Name:SEGEV, SUSAN (MS,CCC-SP)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:SEGEV
Suffix:
Gender:F
Credentials:MS,CCC-SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8939 KNOX AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1831
Mailing Address - Country:US
Mailing Address - Phone:847-679-3621
Mailing Address - Fax:847-679-7867
Practice Address - Street 1:8939 KNOX AVE
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1831
Practice Address - Country:US
Practice Address - Phone:847-679-3621
Practice Address - Fax:847-679-7867
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist