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NPI 1568720365

NPI 1568720365 : DEBORAH KUSHNER KROSNICK SLP-CCC : DEERFIELD, IL

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General NPI Number Information
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    NPI Number           |    1568720365
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    Entity Type          |    Individual 
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    Provider Name        |    DEBORAH KUSHNER KROSNICK SLP-CCC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/30/2012
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    Last Update Date     |    04/30/2012
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Provider Practice Location Address
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    Address Line         |    1520 CHAPEL CT 
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    City                 |    DEERFIELD
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    State                |    IL
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    Zip                  |    60015-2213
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    Country              |    US
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    Telephone            |    847-940-8216
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1520 CHAPEL CT 
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    City                 |    DEERFIELD
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    State                |    IL
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    Zip                  |    60015-2213
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    Country              |    US
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    Telephone            |    847-940-8216
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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       |    146.004993
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    License Number State |    IL
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