Provider Demographics
NPI:1992903934
Name:COONEY, MAUREEN GRADY (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:GRADY
Last Name:COONEY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MRS
Other - First Name:MAUREEN
Other - Middle Name:TERESE
Other - Last Name:GRADY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:10553 S OAKLEY AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-2525
Mailing Address - Country:US
Mailing Address - Phone:773-841-8180
Mailing Address - Fax:
Practice Address - Street 1:10553 S OAKLEY AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-2525
Practice Address - Country:US
Practice Address - Phone:773-841-8180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2014-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146008643235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist