Healthcare Provider Details

I. General information

NPI: 1841107414
Provider Name (Legal Business Name): CARRIE HOSTENY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12915 MAPLE AVE
BLUE ISLAND IL
60406-2014
US

IV. Provider business mailing address

17663 HAAS RD
MOKENA IL
60448-8512
US

V. Phone/Fax

Practice location:
  • Phone: 708-385-5959
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: