Healthcare Provider Details

I. General information

NPI: 1316362429
Provider Name (Legal Business Name): LAURIE KAUZLARIC MS CCC SLP,M.ED.SPED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2014
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 BARTON DR
OSWEGO IL
60543-7735
US

IV. Provider business mailing address

809 BARTON DR
OSWEGO IL
60543-7735
US

V. Phone/Fax

Practice location:
  • Phone: 708-738-0852
  • Fax: 815-723-2455
Mailing address:
  • Phone: 708-738-0852
  • Fax: 815-723-2455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number146010110
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number796765
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number123320
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number34525
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: