Provider Demographics
NPI:1528701562
Name:LAURA SAMBROOKES-MCQUADE, SLPD, CCC-SLP, PLLC
Entity type:Organization
Organization Name:LAURA SAMBROOKES-MCQUADE, SLPD, CCC-SLP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:EHLERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-337-0343
Mailing Address - Street 1:1516 LEGACY CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-1253
Mailing Address - Country:US
Mailing Address - Phone:330-331-5353
Mailing Address - Fax:
Practice Address - Street 1:1516 LEGACY CIR STE 100
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-1253
Practice Address - Country:US
Practice Address - Phone:330-331-5353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAURA SAMBROOKES-MCQUADE, SLPD, CCC-SLP, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-18
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral PediatricsGroup - Multi-Specialty
No224ZF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantFeeding, Eating & SwallowingGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1194867358OtherSTATE OF ILLINOIS