MEDICARE: JORIE ELIZABETH RUSNAK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1427742436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORIE ELIZABETH RUSNAK

Provider Business Mailing Address
First Line	:	7803 W 159TH ST
Second Line	:
City	:	TINLEY PARK
State	:	IL
Zip	:	60477-1343
Country	:	US
Telephone Number	:	708-719-4288
Fax Number	:

Provider Business Practice Location Address
First Line	:	9624 WILLOW LN
Second Line	:
City	:	MOKENA
State	:	IL
Zip	:	60448-9318
Country	:	US
Telephone Number	:	708-792-3180
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2023
Last Update Date	:	09/25/2025

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Directions to “ JORIE ELIZABETH RUSNAK ” Practice Location

Language	Start Address	Practice Location

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