Individual ProviderGracie Leeann McnicollSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address1003 N Damen Ave, Chicago, IL 60622-4391(312) 348-6288(406) 291-9226PECOS EnrollmentBased on the most recent information from CMS, provider Gracie Leeann Mcnicoll does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1285516641Provider TypeIndividualFull NameMcnicoll, Gracie LeeannGenderFemaleSole ProprietorNoEnumeration Date7/24/2025Last Updated7/24/2025Contact InformationPractice LocationPractice Address1003 N Damen Ave, Chicago, IL 60622-4391Phone(312) 348-6288FaxUnlisted FaxMailing LocationMailing Address509 W Deming Pl Apt 2s, Chicago, IL 60614-5946Phone(406) 291-9226FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense242.008512Illinois