Provider Demographics
NPI:1932392784
Name:YORK, SUSANNAH F (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SUSANNAH
Middle Name:F
Last Name:YORK
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5820 W. IRVING PARK RD.
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634
Mailing Address - Country:US
Mailing Address - Phone:773-685-8482
Mailing Address - Fax:773-685-8479
Practice Address - Street 1:5820 W. IRVING PARK RD.
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634
Practice Address - Country:US
Practice Address - Phone:773-685-8482
Practice Address - Fax:773-685-8479
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146009078235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist