Provider Demographics
NPI:1245811983
Name:SUAREZ, DENISE (SLP)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-4369
Mailing Address - Country:US
Mailing Address - Phone:708-358-1186
Mailing Address - Fax:
Practice Address - Street 1:39 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-4369
Practice Address - Country:US
Practice Address - Phone:708-358-1186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146005814235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist