Provider Demographics
NPI:1518424308
Name:NUDELMAN, RUTH (MACCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:
Last Name:NUDELMAN
Suffix:
Gender:F
Credentials:MACCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4334 MEADOWLARK CT
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-2762
Mailing Address - Country:US
Mailing Address - Phone:847-269-3156
Mailing Address - Fax:
Practice Address - Street 1:4334 MEADOWLARK CT
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-2762
Practice Address - Country:US
Practice Address - Phone:847-269-3156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist