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General NPI Number Information
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NPI Number | 1063789378
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Entity Type | Individual
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Provider Name | LAURA R. NATALINO-CZOSNYKA MHS CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 11/30/2011
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Last Update Date | 06/27/2020
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Provider Practice Location Address
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Address Line | 190 S PROSPECT AVE
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City | ELMHURST
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State | IL
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Zip | 60126-3271
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Country | US
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Telephone | 630-617-3588
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 172
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City | MOUNT PROSPECT
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State | IL
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Zip | 60056-0172
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 242001792
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License Number State | IL
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