Provider Demographics
NPI:1699013219
Name:GRADY COONEY SPEECH PARTNERS, LTD
Entity Type:Organization
Organization Name:GRADY COONEY SPEECH PARTNERS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:GRADY
Authorized Official - Last Name:COONEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP, COM
Authorized Official - Phone:773-841-8180
Mailing Address - Street 1:4560 W 103RD ST
Mailing Address - Street 2:UNIT 2
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-4869
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4560 W 103RD ST
Practice Address - Street 2:UNIT 2
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-4869
Practice Address - Country:US
Practice Address - Phone:773-841-8180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-17
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X, 261QH0700X
IL68557372252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Multi-Specialty