Provider Demographics
NPI:1053131953
Name:DEMAS, LEAH
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:DEMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MAE
Other - Middle Name:
Other - Last Name:DEMAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:410 ROYAL ST GEORGE
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-4570
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8151 W LAWRENCE AVE
Practice Address - Street 2:
Practice Address - City:NORRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60706-3136
Practice Address - Country:US
Practice Address - Phone:708-456-8848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist