Provider Demographics
NPI:1154582807
Name:GRICUS, CLAUDIA ELENA (MHS/CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CLAUDIA
Middle Name:ELENA
Last Name:GRICUS
Suffix:
Gender:F
Credentials:MHS/CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21241 CONEFLOWER DR
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-1957
Mailing Address - Country:US
Mailing Address - Phone:815-464-2787
Mailing Address - Fax:
Practice Address - Street 1:21241 CONEFLOWER DR
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-1957
Practice Address - Country:US
Practice Address - Phone:815-464-2787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146007294235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist