Provider Demographics
NPI:1790266914
Name:LAPRAIRIE, CANDACE MICHELLE (MS)
Entity Type:Individual
Prefix:MS
First Name:CANDACE
Middle Name:MICHELLE
Last Name:LAPRAIRIE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 W MADISON ST
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-3317
Mailing Address - Country:US
Mailing Address - Phone:630-827-4400
Mailing Address - Fax:
Practice Address - Street 1:150 W MADISON ST
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-3317
Practice Address - Country:US
Practice Address - Phone:630-827-4572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-25
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.004827235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist