Provider Demographics
NPI:1649309766
Name:PERLIN, WENDY SUE (MACCC SLP)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:SUE
Last Name:PERLIN
Suffix:
Gender:F
Credentials:MACCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21378 PRESCOTT CT
Mailing Address - Street 2:
Mailing Address - City:KILDEER
Mailing Address - State:IL
Mailing Address - Zip Code:60047-8859
Mailing Address - Country:US
Mailing Address - Phone:847-842-4057
Mailing Address - Fax:847-842-4059
Practice Address - Street 1:1025 OLD MCHENRY RD
Practice Address - Street 2:
Practice Address - City:LAKE ZURICH
Practice Address - State:IL
Practice Address - Zip Code:60047-8428
Practice Address - Country:US
Practice Address - Phone:847-842-4057
Practice Address - Fax:847-842-4059
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146000639235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist