Provider Demographics
NPI:1710008552
Name:DIFILIPPO, SUZANNE D (MS CCC SLPL)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:D
Last Name:DIFILIPPO
Suffix:
Gender:F
Credentials:MS CCC SLPL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4102 BELMONT PT
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61822
Mailing Address - Country:US
Mailing Address - Phone:217-366-0033
Mailing Address - Fax:217-366-0012
Practice Address - Street 1:4102 BELMONT PT
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61822
Practice Address - Country:US
Practice Address - Phone:217-366-0033
Practice Address - Fax:217-366-0012
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0146002018235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist