Provider Demographics
NPI:1184769838
Name:ROSS, JULIE RUTH (MA, CCC, SLP)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:RUTH
Last Name:ROSS
Suffix:
Gender:F
Credentials:MA, CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 W SHERIDAN RD
Mailing Address - Street 2:#1W
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-3225
Mailing Address - Country:US
Mailing Address - Phone:773-244-1944
Mailing Address - Fax:
Practice Address - Street 1:714 W SHERIDAN RD
Practice Address - Street 2:#1W
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-3225
Practice Address - Country:US
Practice Address - Phone:773-244-1944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist