Provider Demographics
NPI:1558975565
Name:RAO, LEELA A (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LEELA
Middle Name:A
Last Name:RAO
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 1:300 E SUPERIOR ST
Mailing Address - Street 2:TARRY 8
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611
Mailing Address - Country:US
Mailing Address - Phone:407-227-4989
Mailing Address - Fax:
Practice Address - Street 1:300 E SUPERIOR ST
Practice Address - Street 2:TARRY 8
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611
Practice Address - Country:US
Practice Address - Phone:407-227-4989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-08
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist