Provider Demographics
NPI:1528306958
Name:ANDREWS, SUSAN N (MS)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:N
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1436 W WOLFRAM ST
Mailing Address - Street 2:UNIT 2
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-4117
Mailing Address - Country:US
Mailing Address - Phone:314-497-1390
Mailing Address - Fax:
Practice Address - Street 1:1436 W WOLFRAM ST
Practice Address - Street 2:UNIT 2
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-4117
Practice Address - Country:US
Practice Address - Phone:314-497-1390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS206235500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist