Provider Demographics
NPI:1144011909
Name:AGRANOFF, MINDY GRACE (MA)
Entity type:Individual
Prefix:
First Name:MINDY
Middle Name:GRACE
Last Name:AGRANOFF
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:852 W NEWPORT AVE APT 1R
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-3089
Mailing Address - Country:US
Mailing Address - Phone:614-570-1056
Mailing Address - Fax:
Practice Address - Street 1:2506 N CLARK ST STE 158
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-1848
Practice Address - Country:US
Practice Address - Phone:312-278-0022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist