Provider Demographics
NPI:1811004203
Name:GROW AND LEARN THERAPY SERVICES
Entity type:Organization
Organization Name:GROW AND LEARN THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:POPE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP/L
Authorized Official - Phone:773-792-8442
Mailing Address - Street 1:6776 N NORTHWEST HWY STE 1C
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-1297
Mailing Address - Country:US
Mailing Address - Phone:773-792-8442
Mailing Address - Fax:
Practice Address - Street 1:6776 N NORTHWEST HWY STE 1C
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-1297
Practice Address - Country:US
Practice Address - Phone:773-792-8442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty